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The study compares the rate of postoperative pulmonary complications (PPCs) associated with positive end-expiratory pressure (PEEP) > 5 cm H2O and PEEP ≤ 5 cm H2O in patients with obesity undergoing surgery under general anesthesia. Four randomized controlled trials were analyzed, and 2116 participants were included. The primary outcome was a composite of PPCs, including atelectasis, pneumonia, pneumothorax, and acute respiratory failure. The study found no statistically significant difference in PPCs between the PEEP ≤ 5 cm H2O and PEEP > 5 cm H2O groups, although significant heterogeneity was found within the included studies. The study suggests that it is unclear whether PEEP > 5 cm H2O improves the postoperative clinical outcome in patients with obesity.
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