Abstract

Background: Postoperative pulmonary complications (PPC) are common in surgical patients although a lung-protective ventilation strategy approach is used. Driving pressure (δP) is an important component of mechanical ventilation and the research in acute respiratory distress syndrome (ARDS) patients shows that an increase of δP is associated with increased mortality.

Objective: This review analyzes the impact of δP guided Positive End-expiratory Pressure (PEEP) in ventilated patient during general surgery.

Methods: PubMed was searched using the keywords: “driving pressure”, “mechanically ventilated patients”, “surgery” and “anesthesia”. Additional research was added using the references of appropriate studies.

Results: Most studies suggest that δP guided PEEP lowers PPC, however there is no clear consensus depending on the type of surgery. More studies should use objective measurement of δP guided PEEP titration to have a better understanding of its impact on ventilation.

Conclusion: In recent years, personalized medicine has become more prominent. δP guided PEEP may guide personalized ventilator strategy and thus improve the outcome of the anesthetized patient by minimising PPC. More research should be done to understand the impact of δP on postoperative outcomes.