Physiological effects of two driving pressure-based methods to set positive end-expiratory pressure during one lung ventilation.

ABSTRACT: During one-lung ventilation (OLV), titrating the positive end-expiratory pressure (PEEP) to target a low driving pressure (∆P) could reduce postoperative pulmonary complications. However, it is unclear how to conduct PEEP titration: by stepwise increase starting from zero PEEP (PEEP_INCREMENTAL) or by stepwise decrease after a lung recruiting manoeuvre (PEEP_DECREMENTAL). In this randomized trial, we compared the physiological effects of these two PEEP titration strategies on respiratory mechanics, ventilation/perfusion mismatch and gas exchange. Patients undergoing video-assisted thoracoscopic surgery in OLV were randomly assigned to a PEEP_INCREMENTAL or PEEP_DECREMENTAL strategy to match the lowest ∆P. In the PEEP_INCREMENTAL group, PEEP

SUBMITTER: Spadaro S 

PROVIDER: S-EPMC7439797 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature