Positive end-expiratory pressure (PEEP) during anaesthesia for the prevention of mortality and postoperative pulmonary complications

Imberger, Georgina; McIlroy, David R.; Pace, Nathan L.; Wetterslev, Jørn; Brok, Jesper; Møller, Ann Merete

doi:10.1002/14651858.cd007922.pub2

Cited by 44 publications

(18 citation statements)

References 62 publications

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“…Inspired oxygen concentration [80 % has been shown to decrease the prevalence of surgical-site infection [53]. There is insufficient evidence for the use of positive-end expiratory pressure (PEEP) to prevent postoperative pulmonary complications and the impact on mortality [54]. Increased insulin resistance as a result of surgery causes hyperglycemia [55], and this should be avoided because it can lead to postoperative complications [56][57][58].…”

Section: Standard Anaesthetic Protocolmentioning

confidence: 99%

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Nygren¹,

Thacker²,

Carli³

et al. 2012

World j. surg.

1,049

467

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Background This review aims to present a consensus for optimal perioperative care in rectal/pelvic surgery, and to provide graded recommendations for items for an evidenced-based enhanced recovery protocol. Methods Studies were selected with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohorts. For each item of the perioperative treatment pathway, available English-language literature was examined, reviewed and graded. A consensus recommendation was reached after critical appraisal of the literature by the group. Results For most of the protocol items, recommendations are based on good-quality trials or meta-analyses of goodquality trials (evidence grade: high or moderate).

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Section: Standard Anaesthetic Protocolmentioning

confidence: 99%

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Nygren¹,

Thacker²,

Carli³

et al. 2012

World j. surg.

1,049

467

View full text Add to dashboard Cite

show abstract

“…Still, the literature suggests that it should be initiated immediately after or up to the 30th minute following induction and then continued throughout the operation. 2,33 In our study, the mean duration of the surgery was 55 6 4.59 minutes for each rabbit. PEEP was initiated at induction and was continued throughout the surgery.…”

Section: Discussionmentioning

confidence: 73%

“…Serious postoperative respiratory side effects can lead to tissue hypoxia involving deterioration of the ventilation/ perfusion ratio (V/Q). 2 Also, systemic hypoxia may be due to a deficiency in oxygen that affects collagen synthesis and deposition directly, and impairs anastomotic healing in the colon. 3 Indeed, ischemia is a well-known cause of leakage from colonic anastomoses.…”

mentioning

confidence: 99%

“…Positive end-expiratory pressure (PEEP) leads to improved lung compliance, decreased shunting, and higher arterial oxygen pressure (PO 2 ). 1,2 In the data, analysis has shown that an increase in the PO 2 /fraction of inspired oxygen (PO 2 /FiO 2 ) ratio and atelectasis are rarely observed during the postoperative period following intraoperative PEEP application. 2 The efficacy of intraoperative PEEP intervention in relation to postoperative oxygenation and systemic effects is discussed in the literature, although this subject was not found in any studies evaluating colonic anastomosis healing.…”

mentioning

confidence: 99%

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Effect of Intraoperative PEEP Application on Colonic Anastomoses Healing: An Experimental Animal Study

Türkoğlu

Bostancı

Bilgili

et al. 2016

International Surgery

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This study aimed to assess the effect of intraoperative positive end-expiratory pressure (PEEP) intervention on the healing of colonic anastomoses in rabbits. A total of 32 New Zealand type male rabbits were divided into 2 groups of 16 animals each. Following ventilation with tracheostomy, colonic resection and anastomosis were performed in both groups. Although 10 cm of H 2 O PEEP level was applied in group 1 (PEEP), group 2 [zero end-expiratory pressure (ZEEP)] was ventilated without PEEP throughout the surgery. Half of both the PEEP and ZEEP group animals were killed on the third postoperative day, whereas the remaining half were killed on the seventh. Anastomotic bursting pressures, the tissue concentrations in hydroxyproline, and histologic assessments were

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“…Anestezi indüksiyonu ile FRK'deki bu dü-şüş % 10 oranında artar. (3) Böylece genel anestezi atelektaziye yol açar. Supin pozisyon, cerrahi aletlerin abdominal basısı, hava yolları üzerine direkt basınç etkisi ve kompresyon atelektazisi ile genel anestezi sırasında atelektazi gelişebilir.…”

unclassified

What is the Effect of Positive End-expiratory Pressure (PEEP) on Postoperative Pulmonary Complications and Mortality During General Anaesthesia?

Çelebioğlu¹

2011

J Turk Anaesth Int Care

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ÖZETPEEP uygulamasının genel anestezi altında solunum fonksiyonlarını düzelttiği bilinmektedir. PEEP uygulanan hastalarda, PEEP'in postoperatif mortaliteyi ve pnömoni gibi solunum komplikasyonları riskini azaltıp azaltmadığı bilinmemektedir. Günümüzde, intraoperatif PEEP uygulanmasının postoperatif mortalite ve solunum komplikasyonları üzerine etkileri hakkında bir sonuca varmak için henüz yeterli veri mevcut değildir.Anahtar kelimeler: Anestezi, ventilasyon, PEEP, postoperatif mortalite ve solunum hasarı SUMMARY What is the Effect of Positive End-expiratory Pressure (PEEP) on Postoperative Pulmonary Complications and Mortality During General Anaesthesia?It has been known that PEEP can improve respiratory function under general anaesthesia. We do not know whether patients who receive PEEP have a lower risk of postoperative mortality or respiratory complications such as pneumonia. There is currently insufficient evidence to make conclusions about how intraoperative PEEP affects postoperative mortality and respiratory complications.

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Positive end-expiratory pressure (PEEP) during anaesthesia for the prevention of mortality and postoperative pulmonary complications

Cited by 44 publications

References 62 publications

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Effect of Intraoperative PEEP Application on Colonic Anastomoses Healing: An Experimental Animal Study

What is the Effect of Positive End-expiratory Pressure (PEEP) on Postoperative Pulmonary Complications and Mortality During General Anaesthesia?

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Positive end-expiratory pressure (PEEP) during anaesthesia for the prevention of mortality and postoperative pulmonary complications

Cited by 44 publications

References 62 publications

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

Effect of Intraoperative PEEP Application on Colonic Anastomoses Healing: An Experimental Animal Study

What is the Effect of Positive End-expiratory Pressure (PEEP) on Postoperative Pulmonary Complications and Mortality During General Anaesthesia?

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Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Guidelines for Perioperative Care in Elective Rectal/Pelvic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations