Evidence map›Paper›PMID 41107724›Full record

Trial reportBMC anesthesiology2025

Applying positive end-expiratory pressure to facemask ventilation improves post-induction lung atelectasis: a three-arm randomized controlled trial.

Li Yang, Lei Wu, Jingsi Ye, Zhanqi Zhao, Jun Zhang

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06900426 (Lung Atelectasis Improvement Through Positive End Expiratory Pressure During Anesthetic Induction), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT06900426 nacompletednot on this map

Lung Atelectasis Improvement Through Positive End Expiratory Pressure During Anesthetic Induction: a Randomized Trial

TypeinterventionalSponsorFudan UniversityRan2025 to 2025Enrolled120ConditionsLung Injury, AcuteArms10 PEEP, ZEEP, 5PEEP
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Li Yang *Department of Anesthesiology, Fudan University Shanghai Cancer Center, No. 270 DongAn Road, Xuhui District, Shanghai, 200032, China.
Lei Wu *Department of Anesthesiology, Fudan University Shanghai Cancer Center, No. 270 DongAn Road, Xuhui District, Shanghai, 200032, China.
Jingsi YeDepartment of Anesthesiology, Fudan University Shanghai Cancer Center, No. 270 DongAn Road, Xuhui District, Shanghai, 200032, China.
Zhanqi ZhaoDepartment of Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzou, China.
Jun ZhangDepartment of Anesthesiology, Fudan University Shanghai Cancer Center, No. 270 DongAn Road, Xuhui District, Shanghai, 200032, China. snapzhang@aliyun.com.

Funding

National Natural Science Foundation of China No.82301443Science and Technology Commission of Shanghai Municipality No. 22Y11904200
6 · The paper itself

Abstract

backgroundInduction of general anesthesia is associated with rapid-onset lung atelectasis, which increases intrapulmonary shunt and potentially impairs oxygenation. We aimed to evaluate whether applying positive end-expiratory pressure (PEEP) to facemask ventilation during induction of general anesthesia can reduce post-induction lung atelectasis.

methodsIn this single-center, three-arm randomized controlled trial, one hundred and twenty ASA I-II patients undergoing elective non-cardiothoracic cancer surgery under general anesthesia were randomly assigned into three groups. Facemask ventilation was initiated in volume-controlled mode with preassigned PEEP levels (0, 5, or 10 cmH2O) after anesthetic administration. Electrical impedance tomography (EIT) was used to continuously assess lung atelectasis during induction of general anesthesia, including baseline spontaneous breathing, facemask ventilation, and post-intubation mechanical ventilation. The primary outcome was the dorsal change in end-expiratory lung volume (△EELV) 2 min after endotracheal intubation. The secondary outcomes included driving pressure, EIT-derived ventilation homogeneity, systemic hemodynamics, and PaO2/FiO2 ratio.

resultsAtelectasis (defined as △EELV < 0) occurred in both the PEEP0 and PEEP5 groups during facemask ventilation [-58.8% (-110.4%, 4.0%) and − 34.2% (-200%, 19.2%), respectively] and after induction [-26.9% (-127.4%, 33.6%) and − 33.2% (-52.8%, 5.0%), respectively], but not in the PEEP10 group [25.3% (-12%, 104.7%)]. Facemask ventilation with 10 cmH2O PEEP demonstrated better dorsal lung recruitment than both lower PEEP levels (P < 0.05), reduced post-induction driving pressure (P < 0.05), and improved ventilation homogeneity (P < 0.05). Hemodynamics and PaO2/FiO2 ratio were comparable among the three groups.

conclusionsUse of 10 cmH2O PEEP during induction of general anesthesia effectively mitigated dorsal lung collapse by optimizing respiratory mechanics without inducing overdistension and hemodynamic compromise. It is worth investigating whether this improvement can be extended to the postoperative period. TRIAL REGISTRATION NUMBER: NCT06900426 (registered at clinicaltrials, principal investigator: Jun Zhang, registration date: March 17, 2025).

Indexed as

Anesthesia, GeneralPositive-Pressure RespirationPulmonary AtelectasisAdultAgedFemaleHumansIntubation, IntratrachealMaleMiddle AgedElectrical impedance tomographyFacemask ventilationInduction of general anesthesiaLung atelectasisPositive end-expiratory pressure

Identifiers

PMID41107724
PMCPMC12535129

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Registered trials

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.