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June 20, 2026Perioperative MedicineOpen Access

Individualized PEEP titration guided by static lung compliance reduces postoperative atelectasis in elderly patients during laparoscopic Trendelenburg surgery: a randomized controlled trial

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Authors

JLJinze LiXCXuepeng CaoLHLiquan Huang

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Overview

Randomized trial shows individualized PEEP improves outcomes in elderly patients during laparoscopic surgery, suggesting lung protection.

Key Points

  • To assess the impact of individualized PEEP titration based on static lung compliance to reduce postoperative atelectasis in elderly patients during laparoscopic surgery.
  • Seventy elderly patients aged 65–75 scheduled for laparoscopic rectal cancer surgery were enrolled.
  • Patients were divided into two groups: individualized PEEP (CV group) and fixed PEEP (DV group).
  • Lung ultrasound scores and blood samples were collected at various time points during the surgical procedure.
  • The CV group had significantly lower lung ultrasound scores at T4 (mean difference: -4.0, 95% CI: -7.0 to -2.0) and T5 (mean difference: -4.06, 95% CI: -6.3 to -1.7).
  • SP-A levels were significantly higher in the CV group at T5 (median difference: 33.39, 95% CI: 15.90 to 47.44).
  • Individualized PEEP led to increased dynamic and static compliance and decreased driving pressure at T3 and T4 (all p < 0.05).

Cite This Study

Li et al. (2026) studied this question.

synapsesocial.com/papers/6a3631a1db0793dc1a538744https://doi.org/10.1186/s13741-026-00708-y
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pulmonary effects of aging2017 · 43 citations
  2. 2Positive End-expiratory Pressure and Distribution of Ventilation in Pneumoperitoneum Combined with Steep Trendelenburg Position2019 · 103 citations
  3. 3Impact of a positive end-expiratory pressure on oxygenation, respiratory compliance, and hemodynamics in obese patients undergoing laparoscopic surgery in reverse Trendelenburg position: a systematic review and meta-analysis of randomized controlled trials2025 · 8 citations
  4. 4Individualized Positive End-expiratory Pressure on Postoperative Atelectasis in Patients with Obesity: A Randomized Controlled Clinical Trial2023 · 56 citations
  5. 5Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery2016 · 671 citations