Effects of tidal volume on physiology and clinical outcomes in patients with one‑lung ventilation undergoing surgery: A meta‑analysis of randomized controlled trials
There is no detailed study on how tidal volume (VT) affects patients during one-lung ventilation (OLV). The present study conducted a meta-analysis to assess the effect of VT on physiology and clinical outcomes in OLV patients. Databases until February 2023 were retrieved from PubMed, Cochrane Libra...
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Published in | Biomedical reports Vol. 20; no. 5; p. 73 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Spandidos Publications
01.05.2024
Spandidos Publications UK Ltd D.A. Spandidos |
Subjects | |
Online Access | Get full text |
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Summary: | There is no detailed study on how tidal volume (VT) affects patients during one-lung ventilation (OLV). The present study conducted a meta-analysis to assess the effect of VT on physiology and clinical outcomes in OLV patients. Databases until February 2023 were retrieved from PubMed, Cochrane Library and Web of Science. Randomized controlled trials comparing the application of low and high VT ventilation in adults with OLV were performed. Demographic variables, VT, physiology, and clinical outcomes were retrieved. The random-effects model calculated the summary of odds ratios with 95% confidence intervals (CI) and mean difference with standard deviation. A total of 12 studies involving a total of 876 participants met the inclusion criteria. Low VT ventilation was associated with decreased risk of acute lung injury [relative risk 0.50, 95% CI (0.28, 0.88), P=0.02]. Low VT ventilation decreased the driving pressure (ΔP) and peak pressure (Ppeak) and improved arterial oxygen pressure (PaO
)/fraction of inspired oxygen (FiO
). Furthermore, the present study suggested that a significant difference in blood IL-6 was observed between low and high VT ventilation [mean difference, -35.51 pg/ml, 95% CI (-66.47, -4.54 pg/ml), P=0.02]. A decrease in the length of stay at the hospital occurred in the low VT group when set to 4-5 ml/kg. In the OLV patients, low VT ventilation decreased the risk of acute lung injury, blood IL-6, ΔP and Ppeak, and improved PaO
/FiO
. Furthermore, when low VT was set to 4-5 ml/kg, the length of stay at the hospital decreased. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Abbreviations: VT, tidal volume; ARDS, acute respiratory distress syndrome; OLV, one-lung ventilation; PEEP, positive end-expiratory pressure; RCT, randomized controlled trials; ΔP, driving pressure; Ppeak, peak pressure; RR, relative risk; CI, confidence interval; FiO2, fraction of inspired oxygen; RM, recruitment manoeuvres |
ISSN: | 2049-9434 2049-9442 |
DOI: | 10.3892/br.2024.1761 |