The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study

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The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study

Mazzinari, Guido (författare): Hosp Univ & Politecn La Fe, Res Grp Perioperat Med, Avinguda Fernando Abril Martorell 106, Valencia 46026, Spain.;Hosp Univ & Politecn La Fe, Dept Anesthesiol, Valencia, Spain.

Neto, Ary Serpa (författare): Hosp Israelita Albert Einstein, Dept Crit Care Med, Sao Paulo, Brazil.;Univ Sao Paulo, Cardiopulm Dept, Pulm Div, Inst Coracao,Fac Med,Hosp Clin HCFMUSP, Sao Paulo, Brazil.;Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, Lab Expt Intens Care & Anesthesiol LEICA, Amsterdam, Netherlands.

Hemmes, Sabrine N. T. (författare): Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, Lab Expt Intens Care & Anesthesiol LEICA, Amsterdam, Netherlands.

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Hedenstierna, Göran, 1941- (författare): Uppsala universitet,Klinisk fysiologi,Hedenstiernalaboratoriet

Jaber, Samir (författare): Univ Montpellier, INSERM U1046, PhyMedExp, CNRS UMR 9214, Montpellier, France.

Hiesmayr, Michael (författare): Med Univ Vienna, Div Cardiac Thorac Vasc Anesthesia & Intens Care, Vienna, Austria.

Hollmann, Markus W. (författare): Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, Lab Expt Intens Care & Anesthesiol LEICA, Amsterdam, Netherlands.

Mills, Gary H. (författare): Sheffield Teaching Hosp, Operating Serv Crit Care & Anesthesia, Sheffield, S Yorkshire, England.;Univ Sheffield, Sheffield, S Yorkshire, England.

Melo, Marcos F. Vidal (författare): Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02114 USA.

Pearse, Rupert M. (författare): Queen Mary Univ London, London, England.

Putensen, Christian (författare): Univ Hosp Bonn, Dept Anesthesiol & Intens Care Med, Bonn, Germany.

Schmid, Werner (författare): Med Univ Vienna, Div Cardiac Thorac Vasc Anesthesia & Intens Care, Vienna, Austria.

Severgnini, Paolo (författare): Univ Insubria, ASST Settelaghi Osped Circolo & Fdn Macchi, Dept Biotechnol & Sci Life, Varese, Italy.

Wrigge, Hermann (författare): Bergmannstrost Hosp, Dept Anesthesiol Intens Care & Emergency Med Pain, Halle, Germany.

Cambronero, Oscar Diaz (författare): Hosp Univ & Politecn La Fe, Res Grp Perioperat Med, Avinguda Fernando Abril Martorell 106, Valencia 46026, Spain.;Hosp Univ & Politecn La Fe, Dept Anesthesiol, Valencia, Spain.

Ball, Lorenzo (författare): Policlin San Martino Hosp, IRCCS Oncol & Neurosci, Genoa, Italy.;Univ Genoa Italy, Dept Surg Sci & Integrated Diagnost, Genoa, Italy.

de Abreu, Marcelo Gama (författare): Tech Univ Dresden, Dept Anesthesiol & Intens Care Therapy, Pulm Engn Grp, Dresden, Germany.

Pelosi, Paolo (författare): Policlin San Martino Hosp, IRCCS Oncol & Neurosci, Genoa, Italy.;Univ Genoa Italy, Dept Surg Sci & Integrated Diagnost, Genoa, Italy.

Schultz, Marcus J. (författare): Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, Lab Expt Intens Care & Anesthesiol LEICA, Amsterdam, Netherlands.;Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Bangkok, Thailand.;Univ Oxford, Nuffield Dept Med, Oxford, England.

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Hosp Univ & Politecn La Fe, Res Grp Perioperat Med, Avinguda Fernando Abril Martorell 106, Valencia 46026, Spain;Hosp Univ & Politecn La Fe, Dept Anesthesiol, Valencia, Spain. Hosp Israelita Albert Einstein, Dept Crit Care Med, Sao Paulo, Brazil.;Univ Sao Paulo, Cardiopulm Dept, Pulm Div, Inst Coracao,Fac Med,Hosp Clin HCFMUSP, Sao Paulo, Brazil.;Acad Med Ctr, Dept Intens Care, Amsterdam, Netherlands.;Acad Med Ctr, Lab Expt Intens Care & Anesthesiol LEICA, Amsterdam, Netherlands. (creator_code:org_t)

2021-03-19
2021
Engelska.
Ingår i: BMC Anesthesiology. - : BioMed Central (BMC). - 1471-2253 .- 1471-2253. ; 21:1

Relaterad länk:: https://doi.org/10.1...; visa fler...; https://uu.diva-port... (primary) (Raw object); https://bmcanesthesi...; https://urn.kb.se/re...; https://doi.org/10.1...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

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BackgroundIt is uncertain whether the association of the intraoperative driving pressure (Delta P) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average Delta P (Delta P-TW) with PPCs. We also tested the association of Delta P-TW with intraoperative adverse events.MethodsPosthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events.ResultsThe analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. Delta P was lower in open abdominal surgery patients, but Delta P-TW was not different between groups. The association of Delta P-TW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of P-TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001).ConclusionsP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery.Trial registrationLAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Pneumoperitoneum
Laparoscopy
Laparoscopic surgery
Perioperative ventilation
Protective ventilation
PEEP
Respiratory mechanics
Driving pressure

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