Intraoperative Lung-Protective Ventilation
CA-2 · II.D.12.e.1 I.C.2.a.1 II.C.2.a.1.a
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6 points
High PEEP with recruitment maneuvers may reduce postoperative pulmonary complications, especially in laparoscopic surgery (OR 0.67 [0.50 to 0.87]).
PMID 39042027
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Set the ventilator initially to a tidal volume of 6-8 mL/kg predicted body weight with PEEP 5 cmH2O, then individualise the PEEP; when recruiting, use the lowest effective pressure for the shortest effective time.
PMID 31587835
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The dose-response for postoperative pulmonary complications tracks tidal volume, not PEEP: adding high PEEP to an already low tidal volume gave no further reduction.
PMID 25978326
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Lung-protective ventilation cut major pulmonary and extrapulmonary complications after major abdominal surgery from 27.5% to 10.5%, and the need for postoperative ventilation or reintubation from 17% to 5%.
PMID 23902482
kept
In a 69,265-patient registry, a PEEP of 5 cmH2O and a plateau pressure of 16 cmH2O or less were the settings associated with the lowest risk of postoperative respiratory complications.
PMID 26174419
kept
Individualized intraoperative open-lung approach involves recruiting collapsed lung areas and personalizing PEEP to potentially reduce postoperative pulmonary complications compared to strategies tolerating lung collapse.
PMID 39880492
kept
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