Cochrane · systematic review · CD009098

High versus low positive end‐expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome

Santa Cruz, R, Villarejo, F, Irrazabal, C, et al. · Cochrane Database of Systematic Reviews · 2021 · Cochrane Library

Emergency and Critical Care2 versionsAMSTAR 2: not assessed

SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.

Questions

current version

GRADE rated

No studies

Included studies

No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 4 · 66.7%Moderate 2 · 33.3%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

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High levels of PEEP compared to low levels of PEEP for patients with acute lung injury and acute respiratory distress syndrome

Population: patients with acute lung injury and acute respiratory distress syndrome

6 questions

Outcome	Effect	Evidence	Status / GRADE
Mortality before hospital discharge High levels of PEEP vs low levels of PEEP	RR 0.97 [0.9, 1.04]	7 studies · 3640 participants	Moderate Downgraded: risk of bias, inconsistency, indirectness
Oxygen efficiency (PaO₂/FIO₂) Day 1 High levels of PEEP vs low levels of PEEP	no estimate extracted	6 studies · 2594 participants	Low Downgraded: risk of bias, inconsistency, indirectness
Oxygen efficiency (PaO₂/FIO₂) Day 3 High levels of PEEP vs low levels of PEEP	no estimate extracted	6 studies · 2309 participants	Low Downgraded: risk of bias, inconsistency, indirectness
Oxygen efficiency (PaO₂/FIO₂) Day 7 High levels of PEEP vs low levels of PEEP	no estimate extracted	5 studies · 1611 participants	Moderate Downgraded: risk of bias, inconsistency, indirectness
Barotrauma High levels of PEEP vs low levels of PEEP	RR 1 [0.64, 1.57]	9 studies · 3791 participants	Low Downgraded: risk of bias, inconsistency, indirectness
Ventilator‐free days until Day 28 (only studies reporting means) High levels of PEEP vs low levels of PEEP	no estimate extracted	3 studies · 1654 participants	Low