Lung protective ventilation in patients undergoing major surgery: a systematic review protocol

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Respiratory Physiology

Background:

• Low tidal volume ventilation is increasingly considered for patients under general anesthesia.
• Evidence regarding its benefits remains debated, with conflicting research findings.
• This protocol outlines a systematic review and meta-analysis to address this uncertainty.

Purpose of the Study:

• To systematically review and meta-analyze the beneficial effects of low tidal volume ventilation in patients undergoing general anesthesia.
• To compare low tidal volume (protective) ventilation against conventional ventilation strategies.

Main Methods:

• Comprehensive literature search across PubMed, Scopus, Embase, and EBSCO databases.
• Inclusion of patients undergoing general anesthesia, regardless of surgical type.
• Assessment of trial quality using Delphi consensus; meta-analysis employing conventional and Bayesian approaches.
• Investigation of heterogeneity through subgroup analysis and meta-regression.

Main Results:

• Outcomes include new onset lung injury, atelectasis, arrhythmia, inflammatory biomarkers, oxygenation, carbon dioxide levels, and alveolar-arterial oxygen gradient.
• Data synthesis will utilize conventional meta-analysis techniques.
• Bayesian methods will be applied for binary outcome data synthesis.

Conclusions:

• The findings will provide a comprehensive evaluation of low tidal volume ventilation's impact on patient outcomes.
• This systematic review aims to inform clinical practice regarding protective ventilation strategies in anesthesia.
• Results will be disseminated through peer-reviewed publication and electronic/print media.