Effect of Driving Pressure-Oriented Ventilation on Patients Undergoing One-Lung Ventilation During Thoracic Surgery: A Systematic Review and Meta-Analysis

Li, Xuan; Xue, Wenqiang; Zhang, Qinyu; Zhu, Yu; Yu, F. Richard; Huang, Jie

doi:10.3389/fsurg.2022.914984

Cited by 2 publications

(1 citation statement)

References 36 publications

(72 reference statements)

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“…Currently, values of Pplat of 30 cm H 2 O and ∆P of 15 cm H 2 O are considered the upper limit. Intervention is thus necessary to tailor ventilatory care[ 69 - 71 ].…”

Section: Clinical Outcomesmentioning

confidence: 99%

Driving pressure in mechanical ventilation: A review

Zaidi,

Shaikh,

Khan

et al. 2024

World J Crit Care Med

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Driving pressure (∆P) is a core therapeutic component of mechanical ventilation (MV). Varying levels of ∆P have been employed during MV depending on the type of underlying pathology and severity of injury. However, ∆P levels have also been shown to closely impact hard endpoints such as mortality. Considering this, conducting an in-depth review of ∆P as a unique, outcome-impacting therapeutic modality is extremely important. There is a need to understand the subtleties involved in making sure ∆P levels are optimized to enhance outcomes and minimize harm. We performed this narrative review to further explore the various uses of ∆P, the different parameters that can affect its use, and how outcomes vary in different patient populations at different pressure levels. To better utilize ∆P in MV-requiring patients, additional large-scale clinical studies are needed.

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“…Currently, values of Pplat of 30 cm H 2 O and ∆P of 15 cm H 2 O are considered the upper limit. Intervention is thus necessary to tailor ventilatory care[ 69 - 71 ].…”

Section: Clinical Outcomesmentioning

confidence: 99%

Driving pressure in mechanical ventilation: A review

Zaidi,

Shaikh,

Khan

et al. 2024

World J Crit Care Med

View full text Add to dashboard Cite

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Effects of starting one lung ventilation and applying individualized PEEP right after patients are placed in lateral decubitus position on intraoperative oxygenation for patients undergoing thoracoscopic pulmonary lobectomy: study protocol for a randomized controlled trial

Wang,

Zhou,

Wang

et al. 2024

Preprint

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Background: For patients receiving one lung ventilation in thoracic surgery, numerous studies have proved the superiority of lung protective ventilation of low tidal volume combined with recruitment maneuvers (RM) and individualized PEEP. However, RM may lead to overinflation which aggravates lung injury and intrapulmonary shunt. In most previous studies, RM or PEEP was not applied until atelectasis has already formed. Because atelectasis usually does not develop the moment patients are turned into lateral decubitus position, we hypothesize that applying sufficient PEEP without RM immediately after patients are turned into that position is as effective to prevent atelectasis and thus improve oxygenation as applying PEEP with RM. Methods: A total of 84 patients scheduled for elective pulmonary lobe resection necessitating one lung ventilation will be recruited and randomized to the study group and the control group. For patients in the study group , one lung ventilation will be initiated right after the position of double lumen tube in lateral decubitus position is adjusted, and then individualized PEEP titration is applied. For patients in the control group, one lung ventilation will not be initiated until pleura is opened; and after the initiation, RM will be performed followed by individualized PEEP titration. The primary endpoint will be oxygenation index. Secondary endpoints will include intrapulmonary shunt, respiratory mechanics, PPCs, and hemodynamic indicators. Discussion: Numerous previous studies compared the effects of individualized PEEP applied alone with that applied in combination with RM on oxygenation index, PPCs, intrapulmonary shunt and respiratory mechanics after atelectasis was formed in patients receiving one lung ventilation during thoracoscopic surgery. In this study, we will apply individualized PEEP before the formation of atelectasis while not performing RM in patients allocated to the study group, and then we’re going to observe its effects on the aspects mentioned above. The results of this trial will provide a ventilation strategy that not only improves intraoperative oxygenation but also avoids the detrimental effects of RM for patients receiving one lung ventilation. Trial registration: www.Chictr.org.cn ChiCTR2400080682. Registered on February 5, 2024.

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Effect of Driving Pressure-Oriented Ventilation on Patients Undergoing One-Lung Ventilation During Thoracic Surgery: A Systematic Review and Meta-Analysis

Cited by 2 publications

References 36 publications

Driving pressure in mechanical ventilation: A review

Driving pressure in mechanical ventilation: A review

Effects of starting one lung ventilation and applying individualized PEEP right after patients are placed in lateral decubitus position on intraoperative oxygenation for patients undergoing thoracoscopic pulmonary lobectomy: study protocol for a randomized controlled trial

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