The utility of Electrical Impedance Tomography (EIT)-guided Positive End-Expiratory Pressure (PEEP) titration in Acute Respiratory Distress Syndrome (ARDS): A systematic review and meta-analysis of randomized control trials

Electrical Impedance Tomography (EIT) is a non-invasive imaging technique that uses changes in electrical conductivity to create images of the lungs. The utility of Electrical Impedance Tomography (EIT)-guided Positive End-Expiratory Pressure (PEEP) titration in improving outcomes in with Acute Respiratory Distress Syndrome (ARDS) patients in comparison to traditional PEEP titration methods. Methods Extensive electronic database screening was done until 1st April 2023. Randomized Controlled Trials (RCT) evaluating the impact of the EIT-guided PEEP titration were included in this meta-analysis. Results Our search retrieved six RCTs with a total of 475 patients. No significant difference in P/F ratio [MD = −6.35;95%CI -19.32 to-6.6; I2 = 0%], driving pressure requirement [MD = −0.29;95%CI -0.84 to 0.25; I2 = 0%], PEEP optimization [MD = 0.05;95%CI -0.46 to 0.56; I2 = 87%], and successful weaning [OR = 1.35; 95% CI 0.8–2.2, I2 = 51%] with the application of EIT-guided PEEP titration. Conclusion EIT-guided PEEP titration is a novel alternative, further well designed studies are needed for substantiating it's utility.