{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:55:47Z","timestamp":1790618147418,"version":"4.1.0"},"reference-count":28,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,9,15]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Although the principle of lung-protective ventilation is widely recognised for preventing postoperative pulmonary complications, the optimal intraoperative ventilation strategies remain uncertain. Accordingly, this umbrella review aims to summarise the existing evidence on intraoperative ventilation strategy, evaluate the certainty of evidence and provide reliable evidence to guide clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will search PubMed, Embase, Cochrane Library and Web of Science from database inception to October 2026 for meta-analyses of randomised controlled trials on intraoperative mechanical ventilation. The search will be updated before submission of the final review. Study selection, data extraction and quality assessment will be carried out independently by two reviewers. Methodological quality will be appraised using AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews 2), while evidence certainty will be evaluated using a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. To reconcile potential inconsistencies across meta-analyses, the Jadad decision algorithm will be applied to guide the selection of the best available evidence. Evidence maps will be generated to visually synthesise the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This review relies on already published meta-analyses, and thus no ethics approval is required. The final manuscript will be submitted to a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251102617.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-121689","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:00:44Z","timestamp":1790614844000},"page":"e121689","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Umbrella review protocol of meta-analyses on intraoperative protective ventilation"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1673-8941","authenticated-orcid":false,"given":"Fang","family":"Song","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingxia","family":"Wang","sequence":"additional","affiliation":[{"name":"Jiayuguan First People\u2019s Hospital, jiayuguan, gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengwen","family":"Song","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiling","family":"Wan","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 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