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Table 1 Characteristics and impact of protective ventilation in surgical patients

From: Protective mechanical ventilation in the non-injured lung: review and meta-analysis

     Protective ventilation Standard ventilation  
First author, Year[Ref] No Design Patient population Tidal volume PEEP(cmH2O) Tidal volume PEEP(cmH2O) Main outcome of protective ventilation
Chaney 2000 [14] 25 RCT CABG 6 ml/kg ≥ 5 12 ml/kg ≥ 5 Better lung mechanics and less shunt
Wrigge 2004 [18] 62 RCT Major thoracic or abdominal surgery 6 ml/kg IBW 10 12 or 15 ml/ kg IBW 0 No difference in BAL or plasma cytokines
Koner 2004 [15] 44 RCT CABG 6 ml/kg 5 10 ml/kg 10 ml/kg 50 No difference in plasma cytokines, better oxygenation in PEEP groups
Wrigge 2005 [16] 44 RCT CABG 6 ml/kg IBW 9a 12 ml/kg IBW 7a No difference in BAL and plasma cytokines
Zupancich 2005 [17] 40 RCT CABG 8 ml/kg 10 10 ml/kg 2-3 Decrease in BAL and plasma cytokines
Cai2006 [27] 16 RCT Neurosurgery 6 ml/kg 0 10 ml/kg 0 No difference in amount of atelectasis or gas exchange
Determann 2008 [26] 40 RCT Abdominalsurgery 6 ml/kg IBW 10 12 ml/kg IBW 0 No difference in BAL and plasma of Clara cell protein, advanced glycation end products and surfactant proteins
Wolthuis 2008 [19] 40 RCT Abdominalsurgery 6 ml/kg IBW 10 12 ml/kg IBW 0 Attenuated the increase in BAL myeloperoxidase
Weingarten 2010 [20] 40 RCT Abdominal surgery Age > 65 years 6 ml/kg PBWb 12 10 ml/kg PBW 0 Better intraoperative oxygenation, no difference in biomarkers
Fernandez-Bustamante 2011 [22] 429 Crosssectional Abdominalsurgery < 8 ml/kg PBW 8-10 ml/kg PBW - 10 mL/kg PBW - Obesity, female gender or short height risk factors for receiving large VT
Sundar 2011 [28] 149 RCT Cardiac surgery 6 ml/kg PBW ≥ 5a 10 ml/kg PBW ≥ 5a Less postoperative reintubation and intubated patients at 6-8 hours after surgery.
Lellouche 2012 [21] 3434 Observational Cardiac surgery < 10 ml/kg PBW - 10-12 ml/kg PBW > 12 ml/kg PBW - - VT > 10 ml/kg independent risk factor for organ failure and prolonged ICU stay
Treschan 2012 [23] 101 RCT Upperabdominalsurgery 6 ml/kg PBW 5 12 ml/kg PBW 5 Did not improve lung function
Severgnini 2013 [24] 56 RCT Open abdominal surgery 7 ml/kg IBWb 10 9 ml/kg IBW 0 Better pulmonary function test and mCPIS score, fewer chest X-ray findings.
Futier 2013 [25] 400 RCT Major abdominal surgery 6-8 ml/kg PBWb 6-8 10-12 ml/kg PBW 0 Less postoperative pulmonary and extra pulmonary complications.
  1. No: number of patients; CABG: coronary artery bypass surgery; BAL: bronchoalveolar lavage; IBW: ideal body weight; PBW: predicted body weight; RCT: randomized control trial; ICU: intensive care unit; MV: mechanical ventilation; tidal volume; mCPIS: modified Clinical Pulmonary Infection Score.
  2. a Level of PEEP set according to the sliding scale based on PaO2/FiO2 ladder.
  3. b With recruitment maneuver.