Table 1 Study characteristics
Study | Study design | Surgery | Position | N total | TV (ml/kg) | PEEP (cmH2O) | Mean age (years) | BMI (kg/m2) | n | ASA | Strategy classification | HD complications | RM |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Kwak HJ et al. (2012) | Single centre | Laparoscopic cholecystectomy | RT | 60 | 8 | 0 | 41.8 ± 9.3 | < 30 (24,1) | 30 | I | LPEEP | NB |  |
8 | 10 | 43.3 ± 12.0 | < 30 (24,3) | 30 | HPEEP |  |  | ||||||
Russo A et al. (2013) | single centre | pelvic laparoscopic surgery | T | 60 | 8 | 0 | 32.2 ± 5.2 | 22.6 ± 1.2 | 20 | I | LPEEP | NB |  |
8 | 5 | 34.0 ± 4.8 | 22.1 ± 1.5 | 20 | MPEEP |  |  | ||||||
8 | 10 | 33.4 ± 5.3 | 22.3 ± 1.7 | 20 | HPEEP |  |  | ||||||
Baki ED et al. (2014) | Single centre | Laparoscopic surgery | RT, T | 60 | 10 | 0 | 50.2 ± 13.9 | < 30 | 30 | I–II | LPEEP | NB |  |
6 | 5 | 54.5 ± 15.4 | < 30 | 30 | MPEEP |  |  | ||||||
Ela Y et al. (2014) | Single centre | Laparoscopic urologic procedures | T | 81 | 10 | 0 | 61.5 ± 12.5 | 25.6 ± 2.5 | 38 | I–III | LPEEP | NB |  |
6 | 5 | 59.2 ± 11.3 | 25.7 ± 3.2 | 43 | MPEEP |  |  | ||||||
Kundra P et al. (2014) | Single centre | Laparoscopic cholecystectomy | RT | 75 | 10 | 0 | 45.1 ± 11 | 25.0 | 25 | I–II | LPEEP | NB |  |
10 | 5 | 40.4 ± 10.8 | 23.6 | 25 | MPEEP |  |  | ||||||
10 | 10 | 45.4 ± 10.0 | 23.7 | 25 | HPEEP |  |  | ||||||
Karabayirli S et al. (2016) | Single centre | Laparoscopic cholecystectomy | RT | 40 | 8 | 0 | 42.0 ± 13.8 | 27.3 ± 4.6 | 20 | I–II | LPEEP | NB |  |
8 | 10 | 42.6 ± 12.0 | 26.8 ± 5.1 | 20 | HPEEP |  |  | ||||||
He X et al. (2016) | Single centre | Laparoscopic surgery (rectectomy or colectomy) | T | 42 | 6 | PEEP titration | 54.5 ± 7.3 | 24.0 ± 3.4 | 23 | I–II | iPEEP | 2 patients underwent hypotension (MAP < 50 mm Hg for more than 3 min requiring vasoactive drugs) | sustained inflation of the lungs for 40 s to a peak inspiratory pressure (PIP) of 35 cm H2O,16 was done every 45 min. |
6 | PEEP EIT | 56.7 ± 5.6 | 22.8 ± 3.0 | 19 | iPEEP | ||||||||
Sen O et al. (2017) | Single centre | Laparoscopic cholecystectomy | RT | 43 | 8 | 5 | 49.0 ± 13.5 | < 30 | 20 | I–II | MPEEP | NB |  |
8 | 10 | 43.5 ± 12.6 | < 30 | 23 | HPEEP |  |  | ||||||
Chin JH et al. (2017) | single centre | robot-assisted laparoscopic radical prostatectomy | T | 38 | 8 | 0 | 65.1 ± 6.9 | 25.7 ± 3.1 | 19 |  | LPEEP | NB |  |
8 | 8 | 63.0 ± 6.8 | 25.5 ± 3.5 | 19 | MPEEP |  |  | ||||||
Wang Y et al. (2019) | Single centre | Laparoscopic radical rectectomy or colectomy | T | 54 | 6–8 | 0 | 55.0 ± 10.0 | 24.3 ± 3.0 | 15 | I–II | LPEEP | three patients in PEEP 12 were excluded because of the hypotension (mean arterial pressure < 65 mmHg) that could not be corrected by vasoactive agents (e.g., ephedrine, phenylephrine, perdipine). |  |
6–8 | 4 | 56.0 ± 12.0 | 22.8 ± 2.0 | 15 | MPEEP |  | |||||||
6–8 | 8 | 52.0 ± 13.0 | 23.8 ± 2.1 | 14 | MPEEP |  | |||||||
6–8 | 12 | 53.0 ± 9.0 | 24.0 ± 2.8 | 10 | HPEEP |  | |||||||
Liu J et al. (2019) | Single centre | Laparoscopic radical gastrectomy | RT | 115 | 10 | 0 | 66.1 ± 9.1 | 23.2 ± 2.9 | 57 | I–III | LPEEP | NB | using the sustained airway pressure obtained by the CPAP method and applying 30 cm H2O PEEP for 30 s followed by a decremental PEEP titration procedure directed by static pulmonary compliance (Cstat) |
7 | 6 | 63.2 ± 8.3 | 22.4 ± 2.1 | 58 | MPEEP |  | |||||||
Chun EH et al. (2019) | Single centre | Elective robotic gynaecological surgery | T | 40 | 6 | 4 | 41.0 ± 9.9 | 22.4 ± 3.6 | 20 | I–II | LPEEP | NB |  |
6 | 8 | 37.4 ± 7.8 | 23.4 ± 3.0 | 20 | MPEEP |  |  | ||||||
You AH et al. (2019) | Single centre | Robot-assisted laparoscopic radical prostatectomy | T | 50 | 8 | 0 | 65.3 (7.5) | < 30 | 25 |  | LPEEP | NB |  |
8 | 5 | 65.7 (7.4) | < 30 | 25 | MPEEP |  |  | ||||||
Atashkhoei S et al. (2020) | single centre | gynecologic laparoscopy | T | 60 | 10 | 0 | 30.0 ± 7.4 | < 30 | 20 | I | LPEEP | After PNP was dysrhythmia in nine patients (15%), mostly in the ZEEP and PEEP5 groups. P = 0.004) |  |
10 | 5 | 28.3 ± 6.5 | < 30 | 20 | MPEEP |  | |||||||
10 | 10 | 32.4 ± 7.4 | < 30 | 20 | HPEEP |  | |||||||
Shono A et al. (2020) | Single centre | Robot-assisted laparoscopic prostatectomy | T | 48 | 6–8 | 5 | 66.0 ± 7.0 | 23.0 ± 2.0 | 25 | I–II | MPEEP | NB | The peak inspiratory pressure gradient (above PEEP) was set at 20 cm H2O, and PEEP was progressively increased every three breaths from 5 to 20 in steps of 5 cm H2O to obtain a stepwise increase of peak inspiratory to 30, 35, and 40 cm H2O. The final recruiting pressure of 40 cm H2O was applied for six breaths. The recruitment was completed within 90 s |
6–8 | 15 | 67.0 ± 5.0 | 24.0 ± 2.0 | 23 | HPEEP |  | |||||||
Piriyapatsom A et al. (2020) | Single centre | Laparoscopic Gynaecological surgery | T | 44 | 8 | 5 | 41.3 ± 5.7 | 23.9 ± 4.9 | 22 | I–II | MPEEP | Two patients in the iPEEP and one in the MPEEP developed hypotension after 5 min PNP |  |
8 | PEEP Pes | 41.0 ± 9.3 | 22.7 ± 2.6 | 22 | iPEEP |  | |||||||
Cammarota G et al. (2020) | Single centre | Elective pelvic robotic surgery | T | 28 | 6–8 | 5 | 62.5 ± 9.5 | 25.4 ± 2.6 | 14 | I–II | MPEEP | NB |  |
6–8 | PEEP Pes | 62.8 ± 11.4 | 24.1 ± 4.1 | 14 | iPEEP |  |  | ||||||
Girrbach F et al. (2020) | Single centre | Robot-assisted laparoscopic radical prostatectomy | T | 40 | 8 | 5 | 64.2 (50–76) | 25.6 (2.5) | 20 | I–III | MPEEP | Blood pressure complications iPEEP 8 (40%) and MPEEP 5 (25%) p = 0.50. Norepinephrine infusion 18(90%) and 15 (75%) p = 0.41 respectively. |  |
8 | PEEP EIT | 62.6 (49–76) | 25.3 (2.3) | 20 | iPEEP |  | |||||||
Li H et al. (2021) | Single centre | Laparoscopic colorectal cancer resection | T | 260 | 6–8 | 0 | 70.8 ± 5.8 | 22.3 ± 2.8 | 130 | II–III | LPEEP | More patients in the OLS group than the non-OLS group developed potentially harmful hypotension [OLS vs. non-OLS, 21 (15%) vs. 6 (4.3%); P¼0.004] and needed vasopressors [35 (25%) vs. 12 (8.6%); P < 0.001] intra-operatively. | A stepwise increment of tidal volume was used for each LRM |
6–8 | 6–8 | 69.7 ± 5.8 | 23.0 ± 2.7 | 130 | MPEEP | ||||||||
Nguyen TK et al. (2021) | Single centre | Laparoscopic surgery (gastrectomy, colectomy, Miles’ operation, LAR surgery, others) | RT, T | 62 | 10 | 0 | 55.0 ± 12.0 | 21.0 ± 3.0 | 31 | I–III | LPEEP | NB | RM alveoli were recruited applying a stepwise increase in PEEP (from 4 to 10 cmH2O for 3 breaths, 10 to 15 cmH2O for 3 breaths, and 15 to 20 cmH2O for 10 breaths) with maximum PIP (Peak Inspiratory Pressure) of 50 cmH2O |
7 | 10 | 59.0 ± 9.0 | 21.0 ± 2.0 | 31 | HPEEP |  | |||||||
Huang D et al. (2021) | Single centre | Robot-assisted laparoscopic radical cystectomy | T | 254 | 6 | 0 | 66 (59–73) | 24.0 (3.2) | 127 | I–III | LPEEP | NB |  |
9 | 7 | 64 (59–72) | 23.6 (3.0) | 127 | MPEEP |  |  |