{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:57:06Z","timestamp":1790873826633,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T00:00:00Z","timestamp":1653609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"\n Background<\/jats:title>\n \n Hypoxemia and fluctuations in respiratory mechanics parameters are common during one-lung ventilation (OLV) in thoracic surgery. Additionally, the incidence of postoperative pulmonary complications (PPC\n S<\/jats:sub>\n ) in thoracic surgery is higher than that in other surgeries. Previous studies have demonstrated that driving pressure-oriented ventilation can reduce both mortality in patients with acute respiratory distress syndrome (ARDS) and the incidence of PPC\n S<\/jats:sub>\n in patients undergoing general anesthesia. Our aim was to determine whether driving pressure-oriented ventilation improves intraoperative physiology and outcomes in patients undergoing thoracic surgery.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We searched MEDLINE via PubMed, Embase, Cochrane, Web of Science, and ClinicalTrials.gov and performed a meta-analysis to compare the effects of driving pressure-oriented ventilation with other ventilation strategies on patients undergoing OLV. The primary outcome was the PaO\n 2<\/jats:sub>\n \/FiO\n 2<\/jats:sub>\n ratio (P\/F ratio) during OLV. The secondary outcomes were the incidence of PPC\n S<\/jats:sub>\n during follow-up, compliance of the respiratory system during OLV, and mean arterial pressure during OLV.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This review included seven studies, with a total of 640 patients. The PaO\n 2<\/jats:sub>\n \/FiO\n 2<\/jats:sub>\n ratio was higher during OLV in the driving pressure-oriented ventilation group (mean difference [MD]: 44.96; 95% confidence interval [CI], 24.22\u201365.70.32;\n I<\/jats:italic>\n 2<\/jats:sup>\n : 58%;\n P<\/jats:italic>\n \u2009&lt;\u20090.0001). The incidence of PPC\n S<\/jats:sub>\n was lower (OR: 0.58; 95% CI, 0.34\u20130.99;\n I<\/jats:italic>\n 2<\/jats:sup>\n : 0%;\n P<\/jats:italic>\n \u2009=\u20090.04) and the compliance of the respiratory system was higher (MD: 6.15; 95% CI, 3.97\u20138.32;\n I<\/jats:italic>\n 2<\/jats:sup>\n : 57%;\n P<\/jats:italic>\n \u2009&lt;\u20090.00001) in the driving pressure-oriented group during OLV. We did not find a significant difference in the mean arterial pressure between the two groups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Driving pressure-oriented ventilation during OLV in patients undergoing thoracic surgery was associated with better perioperative oxygenation, fewer PPC\n S<\/jats:sub>\n , and improved compliance of the respiratory system.\n <\/jats:p>\n <\/jats:sec>\n \n Systematic Review Registration<\/jats:title>\n PROSPERO, identifier: CRD42021297063.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fsurg.2022.914984","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T10:34:42Z","timestamp":1654079682000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Effect of Driving Pressure-Oriented Ventilation on Patients Undergoing One-Lung Ventilation During Thoracic Surgery: A Systematic Review and Meta-Analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Xuan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqiang","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1097\/ALN.0000000000002600","article-title":"Driving 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