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. |