PEEP titration by EIT strategies for patients with ARDS: A systematic review and meta-analysis

Yu, Mengnan; Deng, Yulin; Cha, Jun; Jiang, Lingyan; Wang, Mingdeng; Qiao, Shigang; Wang, Chen

doi:10.1016/j.medine.2022.06.020

Cited by 3 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several clinical studies have proven the feasibility and shown potential benefits of EIT-based PEEP titration in patients with ARDS, including improved oxygenation and respiratory system compliance, higher weaning success rate and reduced mortality 22 37. A recent meta-analysis that included 8 clinical trials with a total of 222 patients has demonstrated that EIT-based PEEP titration was associated a with higher PaO 2 /FiO 2 ratio as compared with conventional PEEP setting strategies 38. But the included studies are small-sample trials and only two out of eight are RCT.…”

Section: Discussionmentioning

confidence: 99%

“…22 37 A recent meta-analysis that included 8 clinical trials with a total of 222 patients has demonstrated that EIT-based PEEP titration was associated a with higher PaO 2 /FiO 2 ratio as compared with conventional PEEP setting strategies. 38 But the included studies are small-sample trials and only two out of eight are RCT. Moreover, selection and measurement biases are also concerned in all the studies.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multicentre, parallel, open-label, two-arm, randomised controlled trial on the prognosis of electrical impedance tomography-guided versus low PEEP/FiO2 table-guided PEEP setting: a trial protocol

Wong,

Chi,

Zhang

et al. 2024

BMJ Open

View full text Add to dashboard Cite

IntroductionPrevious studies suggested that electrical impedance tomography (EIT) has the potential to guide positive end-expiratory pressure (PEEP) titration via quantifying the alveolar collapse and overdistension. The aim of this trial is to compare the effect of EIT-guided PEEP and acute respiratory distress syndrome (ARDS) network low PEEP/fraction of inspired oxygen (FiO2) table strategy on mortality and other clinical outcomes in patients with ARDS.MethodsThis is a parallel, two-arm, multicentre, randomised, controlled trial, conducted in China. All patients with ARDS under mechanical ventilation admitted to the intensive care unit will be screened for eligibility. The enrolled patients are stratified by the aetiology (pulmonary/extrapulmonary) and partial pressure of arterial oxygen/FiO2(≥150 mm Hg or <150 mm Hg) and randomised into the intervention group or the control group. The intervention group will receive recruitment manoeuvre and EIT-guided PEEP titration. The EIT-guided PEEP will be set for at least 12 hours after titration. The control group will not receive recruitment manoeuvre routinely and the PEEP will be set according to the lower PEEP/FiO2table proposed by the ARDS Network. The primary outcome is 28-day survival.AnalysisQualitative data will be analysed using the χ2test or Fisher’s exact test, quantitative data will be analysed using independent samples t-test or Mann-Whitney U test. Kaplan-Meier analysis with log-rank test will be used to evaluate the 28-day survival rate between two groups. All outcomes will be analysed based on the intention-to-treat principle.Ethics and disseminationThe trial is approved by the Institutional Research and Ethics Committee of the Peking Union Medical College Hospital. Data will be published in peer-reviewed journals.Trial registration numberNCT05307913.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multicentre, parallel, open-label, two-arm, randomised controlled trial on the prognosis of electrical impedance tomography-guided versus low PEEP/FiO2 table-guided PEEP setting: a trial protocol

Wong,

Chi,

Zhang

et al. 2024

BMJ Open

View full text Add to dashboard Cite

show abstract

“…A otimização da Pressão Expiratória Final Positiva (PEEP) é um elemento crítico no manejo da Síndrome do Desconforto Respiratório Agudo (SDRA) (Heunks et al, 2023;Somhorst et al, 2022). A PEEP ideal representa o ponto de equilíbrio que assegura o recrutamento pulmonar máximo, promovendo uma melhora na oxigenação sem provocar hiperinsuflação pulmonar ou perturbações na hemodinâmica (Kim et al, 2020;Sahetya et al, 2020;Somhorst et al, 2022;Yu et al, 2023).…”

Section: Introductionunclassified

Ultrassonografia pulmonar na titulação de PEEP em pacientes com SDRA: Uma revisão narrativa

Barros,

Lima Filho

2023

RSD

View full text Add to dashboard Cite

Este estudo tem como objetivo verificar através de uma revisão narrativa a importância da ultrassonografia pulmonar na escolha da Pressão Positiva Expiratória Final (PEEP) ideal em pacientes com Síndrome do Desconforto Respiratório Agudo (SDRA). A determinação precisa do nível adequado de PEEP é essencial para otimizar o manejo do SDRA, equilibrando o recrutamento pulmonar e a melhora da oxigenação sem causar efeitos adversos. O artigo explora o papel da ultrassonografia pulmonar na visualização dinâmica das estruturas pulmonares, permitindo a avaliação em tempo real das condições pulmonares. Além disso, são discutidos os métodos para determinar a PEEP e a correlação entre a ultrassonografia pulmonar e a tomografia computadorizada na avaliação da aeração pulmonar. Com base nas evidências disponíveis, esta revisão sugere que a ultrassonografia pulmonar é uma ferramenta incipiente para orientar a escolha da PEEP em pacientes com SDRA, contribuindo para uma abordagem mais personalizada e eficaz no tratamento desses pacientes. Mas devido a poucos estudos realizados até o momento estudos multicêntricos e randomizados, pesquisas devem ser realizadas.

show abstract

Is EIT-guided positive end-expiratory pressure titration for optimizing PEEP in ARDS the white elephant in the room? A systematic review with meta-analysis and trial sequential analysis

Sarkar,

Yalla,

Khanna

et al. 2024

J Clin Monit Comput

View full text Add to dashboard Cite

PEEP titration by EIT strategies for patients with ARDS: A systematic review and meta-analysis

Cited by 3 publications

References 27 publications

Multicentre, parallel, open-label, two-arm, randomised controlled trial on the prognosis of electrical impedance tomography-guided versus low PEEP/FiO2 table-guided PEEP setting: a trial protocol

Multicentre, parallel, open-label, two-arm, randomised controlled trial on the prognosis of electrical impedance tomography-guided versus low PEEP/FiO2 table-guided PEEP setting: a trial protocol

Ultrassonografia pulmonar na titulação de PEEP em pacientes com SDRA: Uma revisão narrativa

Is EIT-guided positive end-expiratory pressure titration for optimizing PEEP in ARDS the white elephant in the room? A systematic review with meta-analysis and trial sequential analysis

Contact Info

Product

Resources

About