Effects of peep on lung injury, pulmonary function, systemic circulation and mortality in animals with uninjured lungs-a systematic review

PROVE Network Investigators

doi:10.21037/atm.2017.12.05

Effects of peep on lung injury, pulmonary function, systemic circulation and mortality in animals with uninjured lungs-a systematic review

PROVE Network Investigators

From the Department of Intensive Care Medicine, Brain Center Rudolf Magnus (C.S.G., A.J.C.S.), Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus (C.S.G., B.H.V., G.J.E.R.), and Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht University, the Netherlands; Department of Critical Care, University Medical Center Groningen...
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Department of Anesthesiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
National Intensive Care Evaluation, Amsterdam, the Netherlands
Department of Surgical Sciences and Integrated Diagnostics, IRCCS San Martino IST, University of Genoa, Genoa, Italy.
Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Groups, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand.

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Abstract

2O, in the 'high PEEP' or 'PEEP' arms, and in the 'low PEEP' or 'no PEEP' arms, respectively. Definitions used for lung injury were quite diverse, as were other outcome measures. The effects of PEEP, at any level, on lung injury was not straightforward, with some trials showing less injury with 'high PEEP' or 'PEEP' and other trials showing no benefit. In most trials, 'high PEEP' or 'PEEP' was associated with improved respiratory system compliance, and better oxygen parameters. However, 'high PEEP' or 'PEEP' was also associated with occurrence of hypotension, a reduction in cardiac output, or development of hyperlactatemia. There were no differences in mortality. The number of trials comparing 'high PEEP' or 'PEEP' with 'low PEEP' or 'no PEEP' in animals with uninjured lungs is limited, and results are difficult to compare. Based on findings of this systematic review it's uncertain whether PEEP, at any level, truly prevents lung injury, while most trials suggest potential harmful effects on the systemic circulation

Original language	English
Pages (from-to)	25
Journal	Annals of translational medicine
Volume	6
Issue number	2
DOIs	https://doi.org/10.21037/atm.2017.12.05
Publication status	Published - Jan 2018

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@article{25511149d7c44664a8e291144b7e6d23,

title = "Effects of peep on lung injury, pulmonary function, systemic circulation and mortality in animals with uninjured lungs-a systematic review",

abstract = "2O, in the 'high PEEP' or 'PEEP' arms, and in the 'low PEEP' or 'no PEEP' arms, respectively. Definitions used for lung injury were quite diverse, as were other outcome measures. The effects of PEEP, at any level, on lung injury was not straightforward, with some trials showing less injury with 'high PEEP' or 'PEEP' and other trials showing no benefit. In most trials, 'high PEEP' or 'PEEP' was associated with improved respiratory system compliance, and better oxygen parameters. However, 'high PEEP' or 'PEEP' was also associated with occurrence of hypotension, a reduction in cardiac output, or development of hyperlactatemia. There were no differences in mortality. The number of trials comparing 'high PEEP' or 'PEEP' with 'low PEEP' or 'no PEEP' in animals with uninjured lungs is limited, and results are difficult to compare. Based on findings of this systematic review it's uncertain whether PEEP, at any level, truly prevents lung injury, while most trials suggest potential harmful effects on the systemic circulation",

author = "Algera, \{Anna Geke\} and Luigi Pisani and Chaves, \{Renato Carneiro de Freitas\} and Amorim, \{Thiago Chaves\} and Thomas Cherpanath and Rogier Determann and Dongelmans, \{Dave A.\} and Frederique Paulus and Tuinman, \{Pieter Roel\} and Paolo Pelosi and \{Gama de Abreu\}, Marcelo and Schultz, \{Marcus J.\} and \{Serpa Neto\}, Ary and \{PROVE Network Investigators\}",

year = "2018",

month = jan,

doi = "10.21037/atm.2017.12.05",

language = "English",

volume = "6",

pages = "25",

journal = "Annals of translational medicine",

issn = "2305-5839",

publisher = "AME Publishing Company",

number = "2",

}

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T1 - Effects of peep on lung injury, pulmonary function, systemic circulation and mortality in animals with uninjured lungs-a systematic review

AU - Algera, Anna Geke

AU - Pisani, Luigi

AU - Chaves, Renato Carneiro de Freitas

AU - Amorim, Thiago Chaves

AU - Cherpanath, Thomas

AU - Determann, Rogier

AU - Dongelmans, Dave A.

AU - Paulus, Frederique

AU - Tuinman, Pieter Roel

AU - Pelosi, Paolo

AU - Gama de Abreu, Marcelo

AU - Schultz, Marcus J.

AU - Serpa Neto, Ary

AU - PROVE Network Investigators

PY - 2018/1

Y1 - 2018/1

N2 - 2O, in the 'high PEEP' or 'PEEP' arms, and in the 'low PEEP' or 'no PEEP' arms, respectively. Definitions used for lung injury were quite diverse, as were other outcome measures. The effects of PEEP, at any level, on lung injury was not straightforward, with some trials showing less injury with 'high PEEP' or 'PEEP' and other trials showing no benefit. In most trials, 'high PEEP' or 'PEEP' was associated with improved respiratory system compliance, and better oxygen parameters. However, 'high PEEP' or 'PEEP' was also associated with occurrence of hypotension, a reduction in cardiac output, or development of hyperlactatemia. There were no differences in mortality. The number of trials comparing 'high PEEP' or 'PEEP' with 'low PEEP' or 'no PEEP' in animals with uninjured lungs is limited, and results are difficult to compare. Based on findings of this systematic review it's uncertain whether PEEP, at any level, truly prevents lung injury, while most trials suggest potential harmful effects on the systemic circulation

AB - 2O, in the 'high PEEP' or 'PEEP' arms, and in the 'low PEEP' or 'no PEEP' arms, respectively. Definitions used for lung injury were quite diverse, as were other outcome measures. The effects of PEEP, at any level, on lung injury was not straightforward, with some trials showing less injury with 'high PEEP' or 'PEEP' and other trials showing no benefit. In most trials, 'high PEEP' or 'PEEP' was associated with improved respiratory system compliance, and better oxygen parameters. However, 'high PEEP' or 'PEEP' was also associated with occurrence of hypotension, a reduction in cardiac output, or development of hyperlactatemia. There were no differences in mortality. The number of trials comparing 'high PEEP' or 'PEEP' with 'low PEEP' or 'no PEEP' in animals with uninjured lungs is limited, and results are difficult to compare. Based on findings of this systematic review it's uncertain whether PEEP, at any level, truly prevents lung injury, while most trials suggest potential harmful effects on the systemic circulation

U2 - 10.21037/atm.2017.12.05

DO - 10.21037/atm.2017.12.05

M3 - Article

C2 - 29430442

SN - 2305-5839

VL - 6

SP - 25

JO - Annals of translational medicine

JF - Annals of translational medicine

IS - 2

ER -

Effects of peep on lung injury, pulmonary function, systemic circulation and mortality in animals with uninjured lungs-a systematic review

Abstract

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