SynthesisCritical care (London, England)2025
Individualized PEEP titration by lung compliance during one-lung ventilation: a meta-analysis.
Synthesis in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Individualised positive end-expiratory pressure to minimise driving pressure and postoperative pulmonary complications in minimally invasive thoracic and abdominal surgery a systematic review and meta-analysis.British journal of anaesthesia · 2026Pooled it
- Effects of preconditioning with one-lung ventilation on perioperative oxygenation and oxidative stress in thoracoscopic surgery: a prospective single-center randomized controlled clinical trial.BMC anesthesiology · 2026Trial
- One-lung ventilation and positive end-expiratory pressure titration.Anaesthesia · 2026Article
- Nuances of perioperative lung isolation and airway management.Journal of thoracic disease · 2026Review
- [WAKWiN minireview: intraoperative ventilation and postoperative pulmonary complications-Current evidence and concepts for lung protection].Die Anaesthesiologie · 2026Review
- Individualized PEEP titration guided by static lung compliance reduces postoperative atelectasis in elderly patients during laparoscopic Trendelenburg surgery: a randomized controlled trial.Perioperative medicine (London, England) · 2026Article
- Does Dynamic Compliance-Guided PEEP Titration Reduce Postoperative Pulmonary Aeration Loss in Laparoscopic Bariatric Surgery? Randomized Controlled Trial.Journal of clinical medicine · 2026Article
- Short-Term Physiological Effects of Moderate PEEP Levels in Invasively Ventilated Patients Without Acute or Chronic Lung Disease.Medical sciences (Basel, Switzerland) · 2026Article
- Postoperative outcomes following anatomical lung resections in relation to intraoperative ventilation practices: a registry-based multicenter study.Frontiers in surgery · 2026Article
- Lung-protective effects of esketamine in patients undergoing video-assisted thoracoscopic surgery: a randomized controlled trial.Journal of thoracic disease · 2025Article
- Tailored single-lung ventilation approaches and postoperative pulmonary outcomes in thoracic surgery.Journal of thoracic disease · 2025Review
- Mechanical Protective Ventilation: New Paradigms in Thoracic Surgery.Journal of clinical medicine · 2025Review
- Impact of intraoperative ventilation parameters on postoperative outcomes in thoracic surgery: a multicenter registry-based analysis.Frontiers in surgery · 2025Article
- Electrical impedance tomography to guide mechanical ventilation for asymmetrical lung injury: a case report.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundDespite the physiological advantages of positive end-expiratory pressure (PEEP), its optimal utilization during one-lung ventilation (OLV) remains uncertain. We aimed to investigate whether individualized PEEP titration by lung compliance is associated with a reduced risk of postoperative pulmonary complications during OLV.
methodsWe searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials until April 1, 2024, to identify published randomized controlled trials that compared individualized PEEP titration by lung compliance with fixed PEEP during OLV. The primary outcome was a composite of postoperative pulmonary complications. Secondary outcomes included clinical outcomes (pneumonia, atelectasis, ARDS, cardiovascular complications, mortality), respiratory mechanics, gas exchanges, and hemodynamic variables. Subgroup analyses were conducted for the primary outcome according to the PEEP titration method (dynamic compliance vs. driving pressure/static compliance, stepwise decremental vs. incremental strategy).
resultsTen trials involving 3426 patients were included. Compared with fixed PEEP, individualized PEEP titration by lung compliance was associated with reduced risk of a composite of postoperative pulmonary complications (eight trials, 3351 patients, risk ratio [RR] 0.55, 95% CI 0.38-0.78). Subgroup analyses suggested the association was evident in the subgroup with titration by dynamic compliance rather than driving pressure/static compliance and in the subgroup with PEEP titration by stepwise decremental but not stepwise incremental strategy. Individualized PEEP titration by lung compliance was also associated with a reduced risk of pneumonia (RR 0.71, 95% CI 0.52-0.96) and atelectasis (RR 0.63, 95% CI 0.45-0.88), higher dynamic compliance, PaO
conclusionsCompared with fixed PEEP, individualized PEEP titration by lung compliance is associated with a reduced risk of postoperative pulmonary complications during OLV, especially in PEEP titration by dynamic compliance or stepwise decremental strategy. It improves respiratory mechanics and oxygenation with no difference in hemodynamic variables. Trial registration number ClinicalTrials.gov (PROSPERO No. CRD42024529980).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.