Intraoperative individualization of positive-end-expiratory pressure through electrical impedance tomography or esophageal pressure assessment: a systematic review and meta-analysis of randomized controlled trials.
Electrical impedance tomography
Esophageal pressure
Intraoperative mechanical ventilation
Intraoperative oxygenation
Pulmonary complications
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
21 Oct 2023
21 Oct 2023
Historique:
received:
11
05
2023
accepted:
09
10
2023
medline:
21
10
2023
pubmed:
21
10
2023
entrez:
20
10
2023
Statut:
aheadofprint
Résumé
This systematic review of randomized-controlled trials (RCTs) with meta-analyses aimed to compare the effects on intraoperative arterial oxygen tension to inspired oxygen fraction ratio (PaO PUBMED®, EMBASE®, and Cochrane Controlled Clinical trials register were searched for observational studies and RCTs from inception to the end of August 2022. Inclusion criteria were: RCTs comparing PEEP titrated on EIT/Pes assessment vs. PEEP not individualized on EIT/Pes and reporting intraoperative PaO Six RCTs were included for a total of 240 patients undergoing general anesthesia for surgery, of whom 117 subjects in the intervention group and 123 subjects in the control group. The intraoperative mean PaO In patients undergoing abdominal or pelvic surgery with an open or laparoscopic/robotic approach, PEEP personalized by EIT or Pes allowed the achievement of a better intraoperative oxygenation compared to PEEP not individualized through EIT or Pes. CRD 42021218306, 30/01/2023.
Identifiants
pubmed: 37863862
doi: 10.1007/s10877-023-01094-2
pii: 10.1007/s10877-023-01094-2
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Fu Y, Zhang YW, Gao J, Fu HM, Si L, Gao YT. Effects of lung-protective ventilation strategy on lung aeration loss and postoperative pulmonary Complications in moderate-risk patients undergoing abdominal Surgery. Minerva Anestesiol. 2021;87:655–62.
doi: 10.23736/S0375-9393.20.14951-4
pubmed: 33325216
Severgnini P, Selmo G, Lanza C, Chiesa A, Frigerio A, Bacuzzi A, et al. Protective mechanical ventilation during general anesthesia for open abdominal Surgery improves postoperative pulmonary function. Anesthesiology United States. 2013;118:1307–21.
doi: 10.1097/ALN.0b013e31829102de
Neto AS, Hemmes SNT, Barbas CSV, Beiderlinden M, Fernandez-Bustamante A, Futier E, et al. Association between driving pressure and development of postoperative pulmonary Complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data. Lancet Respir Med. 2016;4:272–80.
doi: 10.1016/S2213-2600(16)00057-6
pubmed: 26947624
Schultz MJ, Hemmes SNT, Neto AS, Binnekade JM, Canet J, Hedenstierna G, et al. Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary Complications: LAS VEGAS - An observational study in 29 countries. Eur J Anaesthesiol. 2017;34:492–507.
doi: 10.1097/EJA.0000000000000646
Zorrilla-Vaca A, Grant MC, Urman RD, Frendl G. Individualised positive end-expiratory pressure in abdominal surgery: a systematic review and meta-analysis. Br J Anaesth [Internet]. British Journal of Anaesthesia; 2022;129:815–25. https://doi.org/10.1016/j.bja.2022.07.009
Grieco DL, Bongiovanni F, Dell’Anna AM, Antonelli M. Why compliance and driving pressure may be inappropriate targets for PEEP setting during ARDS. Crit Care [Internet]. BioMed Central; 2022;26:4–6. https://doi.org/10.1186/s13054-022-04109-7
McKown AC, Semler MW, Rice TW. Best PEEP trials are dependent on tidal volume. Crit Care Critical Care. 2018;22:21–3.
Chen L, Del Sorbo L, Grieco DL, Junhasavasdikul D, Rittayamai N, Soliman I, et al. Potential for lung recruitment estimated by the recruitment-to-inflation ratio in acute respiratory distress syndrome a clinical trial. Am J Respir Crit Care Med. 2020;201:178–87.
doi: 10.1164/rccm.201902-0334OC
pubmed: 31577153
Cammarota G, Lauro G, Sguazzotti I, Mariano I, Perucca R, Messina A, et al. Esophageal pressure Versus Gas Exchange to Set PEEP during Intraoperative Ventilation. Respir Care. 2020;65:625–35.
doi: 10.4187/respcare.07238
pubmed: 32345760
Girrbach F, Petroff D, Schulz S, Hempel G, Lange M, Klotz C et al. Individualised positive end-expiratory pressure guided by electrical impedance tomography for robot-assisted laparoscopic radical prostatectomy: a prospective, randomised controlled clinical trial. Br J Anaesth [Internet]. P. Simon, Department of Anaesthesiology and Intensive Care, University of Leipzig Medical Centre, Leipzig, Germany; 2020;125:373–82. Available from: https://www.embase.com/search/results?subaction=viewrecord &id=L2007031018&from=export.
Piriyapatsom A, Phetkampang S. Effects of intra-operative positive end-expiratory pressure setting guided by oesophageal pressure measurement on oxygenation and respiratory mechanics during laparoscopic gynaecological surgery: A randomised controlled trial. Eur J Anaesthesiol [Internet]. 2020;37:1032–9. Available from: https://www.embase.com/search/results?subaction=viewrecord &id=L631694346&from=export.
Pereira SM, Tucci MR, Morais CCA, Simões CM, Tonelotto BFF, Pompeo MS et al. Individual Positive End-expiratory Pressure Settings Optimize Intraoperative Mechanical Ventilation and Reduce Postoperative Atelectasis. Anesthesiology. 2018;1–12.
He X, Jiang J, Liu Y, Xu H, Zhou S, Yang S, Electrical Impedance Tomography-guided PEEP Titration in Patients Undergoing Laparoscopic Abdominal Surgery. Med (United States) [Internet]., Shi X et al. Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Fengyang Road 415, Shanghai, China; 2016;95. Available from: https://www.embase.com/search/results?subaction=viewrecord &id=L610171932&from=export.
Nestler C, Simon P, Petroff D, Hammermüller S, Kamrath D, Wolf S, et al. Individualized positive end-expiratory pressure in obese patients during general anaesthesia: a randomized controlled clinical trial using electrical impedance tomography. Br J Anaesth England. 2017;119:1194–205.
doi: 10.1093/bja/aex192
Cammarota G, Simonte R, Longhini F, Spadaro S, Vetrugno L, De Robertis E. Advanced Point-of-care Bedside Monitoring for Acute Respiratory Failure. Anesthesiology. 2023;317–34.
Costa ELV, Borges JB, Melo A, Suarez-Sipmann F, Toufen C, Bohm SH, et al. Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography. Intensive Care Med. 2009;35:1132–7.
doi: 10.1007/s00134-009-1447-y
pubmed: 19255741
Eronia N, Mauri T, Maffezzini E, Gatti S, Bronco A, Alban L et al. Bedside selection of positive end-expiratory pressure by electrical impedance tomography in hypoxemic patients: a feasibility study. Ann Intensive Care. Springer International Publishing; 2017;7.
Zhao Z, Möller K, Steinmann D, Frerichs I, Guttmann J. Evaluation of an electrical impedance tomography-based global inhomogeneity index for pulmonary ventilation distribution. Intensive Care Med. 2009;35:1900–6.
doi: 10.1007/s00134-009-1589-y
pubmed: 19652949
Cammarota G, Santangelo E, Lauro G, Verdina F, Boniolo E, Vita N, De, et al. Esophageal balloon calibration during sigh: a physiologic, randomized, cross-over study. J Crit Care. 2021;61:125–32.
doi: 10.1016/j.jcrc.2020.10.021
pubmed: 33157308
Cammarota G, Verdina F, Santangelo E, Lauro G, Boniolo E, Tarquini R, et al. Oesophageal balloon calibration during pressure support ventilation: a proof of concept study. J Clin Monit Comput Springer Netherlands. 2020;34:1223–31.
doi: 10.1007/s10877-019-00436-3
Cammarota G, Lauro G, Santangelo E, Sguazzotti I, Perucca R, Verdina F et al. Mechanical Ventilation Guided by Uncalibrated Esophageal Pressure May Be Potentially Harmful. Anesthesiology. 2020.
Grasso S, Terragni P, Birocco A, Urbino R, Del Sorbo L, Filippini C, et al. ECMO criteria for Influenza A (H1N1)-associated ARDS: role of transpulmonary pressure. Intensive Care Med. 2012;38:395–403.
doi: 10.1007/s00134-012-2490-7
pubmed: 22323077
Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med. 2008;359:2095–104.
doi: 10.1056/NEJMoa0708638
pubmed: 19001507
pmcid: 3969885
Beitler JR, Sarge T, Banner-Goodspeed VM, Gong MN, Cook D, Novack V et al. Effect of titrating positive end-expiratory pressure (PEEP) with an esophageal pressure–guided strategy vs an empirical high PEEP-F. JAMA. 2019;1–12.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group TP. Preferred reporting items for systematic reviews and Meta-analyses: the PRISMA Statement. Plos Med. 2009;6.
Jonathan ACS, Jelena S, Matthew JP, Roy GE, Natalie SB, Isabelle B et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366.
Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J et al. GRADE guidelines: 1. Introduction d GRADE evidence profiles and summary of findings Table 2011;64.
Wei JJ, Lin EX, Shi JD, Yang K, Hu ZL, Zeng XT, et al. Meta-analysis with zero-event studies: a comparative study with application to COVID-19 data. Mil Med Res Military Medical Research. 2021;8:1–11.
Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–58.
doi: 10.1002/sim.1186
pubmed: 12111919
Spinelli E, Mauri T, Fogagnolo A, Scaramuzzo G, Rundo A, Luca DG, et al. Electrical impedance tomography in perioperative medicine: careful respiratory monitoring for tailored interventions. BMC Anesthesiol BMC Anesthesiology. 2019;19:1–11.
Williams EC, Motta-Ribeiro GC, Vidal Melo MF. Driving pressure and Transpulmonary pressure. Anesthesiology. 2019;131:155–63.
doi: 10.1097/ALN.0000000000002731
pubmed: 31094753
Mojoli F, Iotti GA, Torriglia F, Pozzi M, Volta CA, Bianzina S, et al. In vivo calibration of esophageal pressure in the mechanically ventilated patient makes measurements reliable. Crit Care. 2016;20:98.
doi: 10.1186/s13054-016-1278-5
pubmed: 27063290
pmcid: 4827205
Hemmes SN, Gama de Abreu M, Pelosi P, Schultz MJ. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial. Lancet (london, england) [Internet]. 2014;384:495-503. Available from: https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01071342/full
Bluth T, Serpa Neto A, Schultz MJ, Pelosi P, Gama De Abreu M. Effect of intraoperative high positive end-expiratory pressure (PEEP) with recruitment maneuvers vs low PEEP on postoperative pulmonary Complications in obese patients: a Randomized Clinical Trial. JAMA - J Am Med Assoc. 2019;321:2292–305.
doi: 10.1001/jama.2019.7505
Ferrando C, Soro M, Unzueta C, Suarez-Sipmann F, Canet J, Librero J, et al. Individualised perioperative open-lung approach versus standard protective ventilation in abdominal Surgery (iPROVE): a randomised controlled trial. Lancet Respir Med. 2018;6:168–70.
doi: 10.1016/S2213-2600(18)30024-9
Campos NS, Bluth T, Hemmes SNT, Librero J, Pozo N, Ferrando C et al. Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical trials. Br J Anaesth [Internet]. 2022; Available from: https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02395425/full
Akoumianaki E, Maggiore SM, Valenza F, Bellani G, Jubran A, Loring SH, et al. The application of esophageal pressure measurement in patients with Respiratory Failure. Am J Respir Crit Care Med. 2014;189:520–31.
doi: 10.1164/rccm.201312-2193CI
pubmed: 24467647
Yoshida T, Amato MBP, Grieco DL, Chen L, Lima CAS, Roldan R, et al. Esophageal Manometry and Regional Transpulmonary pressure in Lung Injury. Am J Respir Crit Care Med. 2018;15:1018–26.
doi: 10.1164/rccm.201709-1806OC
Chen L, Grieco DL, Beloncle F, Chen G-Q, Tiribelli N, Madotto F, et al. Partition of respiratory mechanics in patients with acute respiratory distress syndrome and association with outcome: a multicentre clinical study. Intensive Care Med. 2022;48:888–98.
doi: 10.1007/s00134-022-06724-y
pubmed: 35670818
pmcid: 9171739
Boesing C, Schaefer L, Hammel M, Otto M, Blank S, Pelosi P et al. Individualized positive end-expiratory pressure titration strategies in Superobese patients undergoing laparoscopic Surgery: prospective and nonrandomized crossover study. Anesthesiology. 2023;249–61.
Lundin S, Persson P, Larsson A. Driving pressure and survival in the Acute Respiratory Distress Syndrome. JAMA - J Am Med Assoc. 2019;322:581.
doi: 10.1001/jama.2019.7884