ReviewBritish journal of anaesthesia2026
Positive end-expiratory pressure optimisation during general anaesthesia in patients with obesity: a narrative review of respiratory and cardiovascular outcomes.
Review in British journal of anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Obesity: biomechanical implications for mechanical ventilation.Critical care (London, England) · 2026Review
- Comments on "High-frequency low-tidal-volume ventilation reduces loop catheter displacement during pulsed field ablation for pulmonary vein isolation".Journal of anesthesia · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Class III obesity is increasingly prevalent and presents unique perioperative challenges, particularly in the context of general anaesthesia and mechanical ventilation. The altered cardiopulmonary physiology in these patients increases susceptibility to alveolar collapse with impaired respiratory mechanics and gas exchange, significantly contributing to an increased risk of postoperative pulmonary complications. Positive end-expiratory pressure (PEEP) plays a pivotal role in lung-protective ventilation strategies but must be carefully titrated to balance its respiratory benefits against potential cardiovascular compromise. This narrative review explores the dual impact of PEEP on respiratory and cardiovascular outcomes during general anaesthesia in patients with obesity. We examine the obesity-related cardiopulmonary pathophysiology that influences the response to PEEP, including reduced lung compliance, increased pleural pressures, and altered venous return. Evidence from perioperative and critical care literature is synthesised to highlight the importance of PEEP in preventing atelectasis and improving oxygenation, while also considering its potential to impair cardiopulmonary function, particularly at higher levels. This review proposes a physiology-based framework and core recommendations to inform personalised PEEP management during general anaesthesia in patients with obesity, with the objective to optimise lung mechanics while preserving cardiovascular stability. We conclude that a nuanced, physiology-driven strategy to personalise PEEP, integrating respiratory mechanics, gas exchange, and cardiovascular parameters, can help optimise respiratory function and maintain cardiovascular stability in patients with obesity undergoing surgery. However, the clinical impact of such strategies needs to be confirmed in larger studies before they can guide evidence-based perioperative management in this high-risk population.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.