Objective To study the individualized positive end-expiratory pressure(PEEP)ventilation strategy on perioperative lung protection,atelectasis and hemodynamics in patients under general anesthesia.Methods Computer searches of PubMed;clinicaltrials.gov;Web of Science,the Cochrane Library,and CNKI Academic Journal Databases were conducted for all publications in English and Chinese as of January 2023.The reference lists and similar literature of all selected articles were screened.Meta-analysis was performed using RevMan 5.3 software.Results 45 papers with a total of 3 767 patients were studied.Meta-analysis showed there was significantly differences in CC-16 concentrations,lung ultrasound scores,and pulmonary complication rates between individualized PEEP group and the conventional PEEP group(P＜0.05).Individualized PEEP was associated with higher intraoperative dynamic lung compliance and lower driving pressures(P＜0.000 01).However,the individualized PEEP group had no significant effect on MAP(P=0.13)or HR(P=0.94)as compared with the conventional PEEP group.Conclusion Intraoperative use of individualized PEEP increased the perioperative pulmonary protective effect in patients and reduced the incidence and severity of perioperative pulmonary atelectasis.At the same time,it did not cause perioperative hemodynamic instability.
维普
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