EIT-Guided PEEP Linked to Fewer Pulmonary Complications After Laparoscopic Surgery

A single-centre randomised controlled trial compared electrical impedance tomography (EIT)-guided individualised PEEP titration with conventional fixed PEEP of 5 cm H2O in 117 adults undergoing laparoscopic colorectal surgery who were at intermediate to high risk for postoperative pulmonary complications. The trial reported lower driving pressure and a lower 30-day incidence of postoperative pulmonary complications, including atelectasis and pneumonia, in the EIT-guided PEEP group compared with the fixed-PEEP group (49.2% vs 72.4%; hazard ratio 0.53, 95% CI 0.33-0.85, P=0.009). The authors state the findings suggest a role for EIT in intraoperative lung protection.

Most relevant for: Patients at intermediate to high ARISCAT risk for postoperative pulmonary complications undergoing laparoscopic colorectal surgery with pneumoperitoneum and steep Trendelenburg positioning.

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