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oai:repisalud.isciii.es:20.500.12105/267292025-12-18T13:01:17Zcom_20.500.12105_2052com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19612col_20.500.12105_16939col_20.500.12105_16980

00925njm 22002777a 4500 dc Sanchez-Piedra, Carlos author Rodriguez Ortiz de Salazar, Begoña author Roca, Oriol author Prado-Galbarro, Francisco-Javier author Perestelo-Perez, Lilisbeth author Sanchez-Gomez, Luis Maria author 2025-02-26 To assess the efficacy of electrical impedance tomography (EIT)-guided positive end-expiratory pressure (PEEP) titration in improving outcomes for patients with acute respiratory distress syndrome (ARDS). A systematic review and meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials and observational studies with a control group comparing EIT-guided PEEP titration to other strategies were included. Endpoints analysed included mortality, days of mechanical ventilation (MV), intensive care unit (ICU) length of stay (LOS), weaning success rate, barotrauma, driving pressure (∆P), mechanical power (MP), Sequential Organ Failure Assessment (SOFA) score and adverse events. Pooled results were presented as Risk Ratio (RR) for dichotomous outcomes and standardized difference in means (SMD) for continuous outcomes. A total of 4 studies were identified (3 randomized controlled trials and one observational study). All studies were single-center studies (N total = 271 patients). The main limitations were related to potential bias in selecting reported outcomes. EIT-guided PEEP titration was associated with a significant reduction in mortality among critically ill patients with ARDS (RR = 0.64, 95% CI: 0.45-0.91). No significant differences were found in other outcomes. Our findings suggest that EIT may be a valuable tool for PEEP titration in critically ill patients with ARDS. By optimizing lung mechanics, EIT-guided PEEP titration may potentially reduce mortality rates. While larger, multicenter studies are needed to definitively establish the clinical role of EIT in ARDS management, our results provide promising evidence for its potential clinical impact. Sanchez-Piedra C, Rodríguez-Ortiz-de-Salazar B, Roca O, Prado-Galbarro FJ, Perestelo-Perez L, Sanchez-Gomez LM. Electrical impedance tomography for PEEP titration in ARDS patients: a systematic review and meta-analysis. J Clin Monit Comput. 2025 Feb 26. 10.1007/s10877-025-01266-2 1573-2614 1387-1307 Journal of clinical monitoring and computing 40011398 https://hdl.handle.net/20.500.12105/26729 Acute respiratory distress syndrome Positive end-expiratory pressure Critical care Electrical impedance tomography Mechanical ventilation Electrical impedance tomography for PEEP titration in ARDS patients: a systematic review and meta-analysis