Study | Year | Type of patients | N | High PEEP group | Low PEEP group | Main findings | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
N | PEEP | V T | RM | DMV | N | PEEP | V T | RM | DMV | |||||
Surgical ICU patients | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â |
Lago Borges et al. | 2014 | Post-CG | 136b | 44 | 10 | 08 | No | 0.47 | 45 | 05 | 08 | No | 0.47 | Shorter duration of ventilation with higher PEEP (considering only patients extubated within 12Â h after ICU admission) |
Lago Borges et al. | 2013 | Post-CG | 136b | 44 | 10 | 08 | No | 0.47 | 45 | 05 | 08 | No | 0.47 | Higher compliance and less hypoxemia (P/F ratio < 300) with higher PEEP |
Celebi et al. | 2007 | Post-CG | 60a | 20 | 10 | 07 | Yes | 0.25 | 20 | 05 | 07 | No | 0.25 | Increase in P/F ratio (in the first 4Â h but not after extubation) and less atelectasis with higher PEEP |
Holland et al. | 2007 | Post-CG | 28 | 14 | 10 | 6–8 | No | 0.08 | 14 | 05 | 6–8 | No | 0.08 | No differences regarding cardiac index and filling pressures, liver function and gastric mucosal perfusion |
Dyhr et al. | 2002 | Post-CG | 16 | 08 | 15 | 06 | Yes | NA | 08 | 00 | 06 | Yes | NA | Increase in P/F ratio and EELV (in the first 3Â h) and less atelectasis with higher PEEP |
Michalopoulos et al. | 1996 | Post-CG | 67d | 21 | 10 | NA | No | NA | 22 | 00 | NA | No | NA | No differences regarding P/F ratio, duration of ventilation, and atelectasis |
Carroll et al. | 1988 | Postsurgery P/FÂ <Â 200 | 50 | 22 | 15 | 12 | Yes | 15 | 28 | 04 | 12 | Yes | 02 | More hypotension, barotrauma, and death and higher duration of ventilation with higher PEEP |
Marvel et al. | 1986 | Post-CG | 44c | 12 | 10 | 12 | No | 0.39 | 15 | 05 | 12 | No | 0.46 | Lower alveolar–arterial oxygen tension gradient with higher PEEP (similar after extubation). No differences regarding atelectasis, and hospital length of stay |
Murphy et al. | 1983 | Post-CG | 139 | NA | 10 | NA | No | 0.33 | NA | 00 | NA | No | 0.33 | No differences in blood loss independent of coagulation profile |
Zurick et al. | 1982 | Post-CG | 83 | 41 | 10 | NA | No | NA | 42 | 00 | NA | No | NA | No differences regarding the amount of blood loss, need for re-exploration or blood requirement |
Good et al. | 1979 | Post-CG | 24 | 10 | 06 | 11 | No | 0.62 | 14 | 00 | 11 | No | 0.62 | No differences regarding atelectasis, P/F ratio and arterial–alveolar ratio |
Schmidt et al. | 1976 | Post-surgery risk of ARDS | 112 | 56 | 08 | 12–15 | No | NA | 56 | 00 | 12–15 | Yes | NA | Higher PaO2, alveolar–arterial oxygen tension, and lower incidence of ARDS and other pulmonary complications with higher PEEP |
Medical | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â |
Ma et al. | 2014 | NPE | 120 | 60 | 11–30 | 6–8 | No | NA | 60 | 3–10 | 6–8 | No | NA | Lower 28-day mortality, EVLWi, PVPi, blood pressure and higher P/F ratio with high PEEP |
Lesur et al. | 2010 | ARF | 63 | 30 | 05 | 08 | No | 9.2 | 33 | 00 | 07 | No | 9.2 | No differences regarding hypotension, duration of ventilation and mortality (PEEP used only during 90Â min) |
Manzano et al. | 2008 | Clinical P/F > 250 | 127 | 64 | 5–8 | 08 | No | 4.5 | 63 | 00 | 08 | No | 5.6 | No differences regarding hospital mortality, ARDS, atelectasis or barotrauma. Lower incidence of VAP and hypoxemia with high PEEP |
Vigil et al. | 1996 | Trauma | 44 | 23 | 05 | 12 | No | 3.2 | 21 | 00 | 12 | No | 3.6 | No differences regarding intrapulmonary shunt, dead space and P/F ratio |
Cujec et al. | 1993 | ARF | 46 | NA | 10 | NA | No | NA | NA | 00 | NA | No | NA | Reduction in alveolar–arterial oxygen difference and shunt fraction with higher PEEP |
Nelson et al. | 1987 | P/FÂ <Â 250 | 38 | 20 | 15 | NA | No | 5.3 | 18 | 08 | NA | No | 3.4 | No differences in duration of ventilation, ICU and hospital length of stay, barotrauma, and mortality |
Pepe et al. | 1984 | Risk of ARDS | 92 | 44 | 08 | 12 | No | 3.0 | 48 | 00 | 12 | No | 3.0 | No differences regarding ARDS, barotrauma, atelectasis, mortality, duration of ventilation, ICU length of stay |
Weigelt et al. | 1979 | Risk of ARDS | 79 | 45 | 05 | 15 | No | 5.0 | 34 | 00 | 15 | No | 8.0 | Lower incidence of ARDS, and pulmonary mortality and higher incidence of pulmonary dysfunction with higher PEEP |
Feeley et al. | 1975 | ARF | 25 | 12 | 05 | 10 | No | NA | 13 | 00 | 10 | No | NA | Improve in vital capacity and the maximum inspiratory force and less increase in intra-pulmonary shunt with higher PEEP |