Evidence map›Paper›PMID 41966954›Full record

SynthesisBritish journal of anaesthesia2026

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.

Megan Abbott, Richard Ma, Hawwa Chakera, Teruko Kishibe, Martin Girard, Alexis F Turgeon, Ary Serpa Neto, Michael C Sklar, Ashwin Sankar

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Megan AbbottTemerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Richard MaMichael G. Degroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Hawwa ChakeraSchulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Teruko KishibeLibrary Services, St. Michael's Hospital, Toronto, ON, Canada.
Martin GirardDepartment of Anesthesiology, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; Division of Critical Care Medicine, Department of Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada; Imaging and engineering, CHUM Research Center, Montréal, QC, Canada.
Alexis F TurgeonDepartment of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Faculty of Medicine, Université Laval, Québec City, QC, Canada; CHU de Québec - Université Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), Université Laval, Québec City, QC, Canada.
Ary Serpa NetoAustralian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia; Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, VIC, Australia; Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Michael C SklarKeenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, St. Michael's Hospital, Toronto, ON, Canada; Department of Anesthesia, Unity Health Toronto - St. Michael's Hospital and Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
Ashwin SankarKeenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Anesthesia, Unity Health Toronto - St. Michael's Hospital and Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: ashwin.sankar@mail.utoronto.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMechanical ventilation during minimally invasive surgery is associated with postoperative pulmonary complications. Limiting driving pressure appears to reduce pulmonary complications with lung-protective ventilation strategies. Whether individualising PEEP minimises driving pressure to reduce pulmonary complications is unknown. In this systematic review, we assessed whether individualised PEEP strategies during minimally invasive surgery reduce postoperative pulmonary outcomes and driving pressures or both.

methodsWe searched Medline, Central, LILACS, Embase, and Scopus for studies comparing individualised PEEP to lung-protective ventilation in minimally invasive thoracic and abdominal surgery (PROSPERO CRD42023495377). The primary outcome was postoperative pulmonary complication. Random-effects models generated risk ratios (RRs) with 95% confidence intervals (95% CIs) for binary outcomes. We conducted prespecified subgroup analyses by surgery type and post hoc subgroup analyses by individualised PEEP strategy and patient factors. We compared driving pressure differences between individualised PEEP and lung-protective strategies. Statistical heterogeneity was assessed using the I

resultsThirty studies were included (n=3295 participants). Individualised PEEP was associated with reduced risk of postoperative pulmonary complications, compared with lung-protective ventilation (RR=0.67, 95% CI=0.56-0.79, I

conclusionIndividualised PEEP was associated with fewer postoperative pulmonary complications and lower driving pressures during minimally invasive surgery; showing causality requires further research.

Indexed as

AbdomenLung DiseasesMinimally Invasive Surgical ProceduresPositive-Pressure RespirationPostoperative ComplicationsThoracic Surgical ProceduresHumansdriving pressureindividualised PEEPlaparoscopyminimally invasive surgerypostoperative pulmonary complicationspulmonary outcomesthoracoscopy

Identifiers

PMID41966954
PMCPMC13494074

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.