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
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
6
current version
GRADE rated
6
No studies
0
Included studies
NR
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
Current version onlyHigh 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
| 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 |
High versus low levels of PEEP for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome
Population: participants mechanically ventilated, adult participants with acute lung injury and acute respiratory distress syndrome.
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality before hospital discharge High vs low levels of PEEP | RR 0.9 [0.81, 1.01] | 3 studies · 2299 participants | High |
Oxygen efficiency (PaO2/FIO2). Day 1 High vs low levels of PEEP | no estimate extracted | 5 studies · 2337 participants | Moderate Downgraded: inconsistency |
Oxygen efficiency (PaO2/FIO2). Day 3 High vs low levels of PEEP | no estimate extracted | 5 studies · 2059 participants | Moderate Downgraded: inconsistency |
Oxygen efficiency (PaO2/FIO2). Day 7 High vs low levels of PEEP | no estimate extracted | 4 studies · 1379 participants | Moderate Downgraded: inconsistency |
Barotrauma High vs low levels of PEEP | RR 0.97 [0.66, 1.42] | 6 studies · 2504 participants | High |
Ventilator‐free days (only means) High vs low levels of PEEP | no estimate extracted | 2 studies · 644 participants | Moderate Downgraded: inconsistency |