Trial reportEuropean journal of anaesthesiology2025
Positive end-expiratory pressure and emergence preoxygenation after bariatric surgery: effect on postoperative oxygenation: A randomised controlled trial.
Trial report in European journal of anaesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04150276 (Zero Positive End-expiratory Pressure Before Emergence Improves Postoperative Oxygenation in Obese Patients Undergoing Laparoscopic Surgery - a Randomized Clinical Trial), which is not on this map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Zero Positive End-expiratory Pressure Before Emergence Improves Postoperative Oxygenation in Obese Patients Undergoing Laparoscopic Surgery - a Randomized Clinical Trial
Who cites it
3 citing papers in PubMed.
- Dexmedetomidine reduces pulmonary complications in older patients undergoing abdominal laparoscopic surgery: a prospective, single-blinded, randomized controlled trial.BMC anesthesiology · 2026Trial
- Differential effects of propofol and dexmedetomidine on explicit and implicit memory after sedation: a retrospective study.Frontiers in medicine · 2026Article
- Effects of Dexmedetomidine or Propofol on Postoperative Oxygenation Index During Invasive Ventilation in Patients After off-Pump Coronary Artery Bypass Grafting: a Single-Center Retrospective Study.International journal of general medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPositive end-expiratory pressure (PEEP) is important to increase lung volume and counteract airway closure during anaesthesia, especially in obese patients. However, maintaining PEEP during emergence preoxygenation might increase postoperative atelectasis by allowing susceptible lung areas to be filled with highly absorbable oxygen that gets entrapped when small airways collapse due to the sudden loss of PEEP at extubation.
objectiveThis study aimed to test the hypothesis that withdrawing PEEP just before emergence preoxygenation would better maintain postoperative oxygenation.
designProspective, randomised controlled trial.
settingSingle centre secondary hospital in Sweden between December 2019 and January 2023. PATIENTS: A total of 60 patients, with body mass index between 35 and 50 kg m -2 , undergoing laparoscopic bariatric surgery.
interventionIntraoperative ventilation was the same for all patients with a fixed PEEP of 12 or 14 cmH 2 O depending on body mass index. No recruitment manoeuvres were used. After surgery, patients were allocated to maintained PEEP or zero PEEP during emergence preoxygenation.
main outcome measuresThe primary outcome was change in oxygenation from before awakening to 45 min postoperatively as measured by estimated venous admixture calculated from arterial blood gases.
resultsBoth groups had impaired oxygenation postoperatively; in the group with PEEP maintained during awakening, estimated venous admixture increased by mean 9.1%, and for the group with zero PEEP during awakening, estimated venous admixture increased by mean 10.6%, difference -1.5% (95% confidence interval -4.6 to 1.7%), P = 0.354. Throughout anaesthesia, both groups exhibited low driving pressures and superior oxygenation compared with the awake state.
conclusionsWithdrawing PEEP before emergence preoxygenation, did not alter early postoperative oxygenation in obese patients undergoing laparoscopic bariatric surgery. Intraoperative oxygenation was excellent despite using fixed PEEP and no recruitment manoeuvres, but deteriorated after extubation, indicating a need for future studies aimed at improving the emergence procedure. CLINICAL TRIAL NUMBER AND REGISTRY: www.clinicaltrials.gov , NCT04150276.
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