Comparison of high versus low positive end-expiratory pressure for lung-protective ventilation strategies: a meta-analysis / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the effects of high versus low positive end-expiratory pressure (PEEP) for lung-protective ventilation strategies through a meta analysis.Methods:Web of Science, the Cochrane Library, PubMed, EBSCO, Embase, Medline, CNKI, Wanfang data and VIP data were searched from inception to July 15, 2019 for prospective randomized controlled trials involving comparing the effects of ventilation with different levels of PEEP for lung-protective ventilation strategies during operation.Evaluation indexes included incidence of postoperative pulmonary complications and other complications, and incidence of intraoperative hypotension.After two reviewers independently identified the literature and conducted data extraction and quality evaluation, RevMan 5.3 software was used to analyze the data.Results:Eight prospective randomized controlled trials involving 3 324 participants were included.Compared with low PEEP group, no significant change was found in the incidence of postoperative pulmonary complications and other complications ( P>0.05), and the incidence of intraoperative hypotension was significantly increased in high PEEP group ( P<0.05). Conclusion:The effect of lung-protective ventilation strategy with high PEEP is not superior to that with low PEEP.