Methods for determination of individual PEEP for intraoperative mechanical ventilation using a decremental PEEP trial

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dc.creatorFelix Girrbach
dc.creatorFranziska Zeutzschel
dc.creatorSusann Schulz
dc.creatorMirko Lange
dc.creatorAlessandro Beda
dc.creatorAntonio Giannella-Neto
dc.creatorHermann Wrigge
dc.creatorPhilipp Simon
dc.date.accessioned2025-06-04T14:20:57Z
dc.date.accessioned2025-09-08T23:40:45Z
dc.date.available2025-06-04T14:20:57Z
dc.date.issued2022
dc.identifier.doihttps://doi.org/10.3390/jcm11133707
dc.identifier.issn20770383
dc.identifier.urihttps://hdl.handle.net/1843/82778
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofJournal of Clinical Medicine
dc.rightsAcesso Aberto
dc.subjectRespiração Artificial DeCS
dc.subjectImpedância (Eletricidade)
dc.subject.otherelectrical impedance tomography; general anesthesia; mechanical ventilation; positive end-expiratory pressure
dc.subject.otherIndividualised positive end-expiratory pressure guided by electrical impedance tomography
dc.subject.otherElectrical impedance tomography: A compass for the safe route to optimal PEEP
dc.subject.otherApplication of electrical impedance tomography in diagnosis and monitoring of pulmonary diseases
dc.titleMethods for determination of individual PEEP for intraoperative mechanical ventilation using a decremental PEEP trial
dc.typeArtigo de periódico
local.citation.issue13
local.citation.spage3707
local.citation.volume11
local.description.resumo(1) Background: Individual PEEP settings (PEEPIND) may improve intraoperative oxygenation and optimize lung mechanics. However, there is uncertainty concerning the optimal procedure to determine PEEPIND. In this secondary analysis of a randomized controlled clinical trial, we compared different methods for PEEPIND determination. (2) Methods: Offline analysis of decremental PEEP trials was performed and PEEPIND was retrospectively determined according to five different methods (EIT-based: RVDI method, Global Inhomogeneity Index [GI], distribution of tidal ventilation [EIT VT]; global dynamic and quasi-static compliance). (3) Results: In the 45 obese and non-obese patients included, PEEPIND using the RVDI method (PEEPRVD) was 16.3 ± 4.5 cm H2O. Determination of PEEPIND using the GI and EIT VT resulted in a mean difference of −2.4 cm H2O (95%CI: −1.2;−3.6 cm H2O, p = 0.01) and −2.3 cm H2O (95% CI: −0.9;3.7 cm H2O, p = 0.01) to PEEPRVD, respectively. PEEPIND selection according to quasi-static compliance showed the highest agreement with PEEPRVD (p = 0.67), with deviations > 4 cm H2O in 3/42 patients. PEEPRVD and PEEPIND according to dynamic compliance also showed a high level of agreement, with deviations > 4 cm H2O in 5/42 patients (p = 0.57). (4) Conclusions: High agreement of PEEPIND determined by the RVDI method and compliance-based methods suggests that, for routine clinical practice, PEEP selection based on best quasi-static or dynamic compliance is favorable.
local.publisher.countryBrasil
local.publisher.departmentENG - DEPARTAMENTO DE ENGENHARIA ELETRÔNICA
local.publisher.initialsUFMG
local.url.externahttps://www.mdpi.com/2077-0383/11/13/3707

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