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Geo-economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia- posthoc analysis of an observational study in 29 countries

Hol, Liselotte (author)
Locat AMC, Dept Anesthesiol, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands.;Locat AMC, Dept Intens Care, Amsterdam UMC, Amsterdam, Netherlands.
Nijbroek, Sunny G. L. H. (author)
Locat AMC, Dept Anesthesiol, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands.;Locat AMC, Dept Intens Care, Amsterdam UMC, Amsterdam, Netherlands.
Neto, Ary Serpa (author)
Locat AMC, Dept Intens Care, Amsterdam UMC, Amsterdam, Netherlands.;Monash Univ, Australian & New Zealand Intens Care Res Ctr ANZ, Dept Crit Care Med, Melbourne, Vic, Australia.
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Hemmes, Sabrine N. T. (author)
Locat AMC, Dept Anesthesiol, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands.
Hedenstierna, Göran, 1941- (author)
Uppsala universitet,Klinisk fysiologi
Hiesmayr, Michael (author)
Med Univ Vienna, Div Cardiac Thorac Vasc Anesthesia & Intens Care, Vienna, Austria.
Hollmann, Markus W. (author)
Locat AMC, Dept Anesthesiol, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands.
Mills, Gary H. (author)
Sheffield Teaching Hosp, Operating Serv, Crit Care & Anaesthesia, Sheffield, S Yorkshire, England.;Univ Sheffield, Sheffield, S Yorkshire, England.
Melo, Marcos F. Vidal (author)
Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02114 USA.
Putensen, Christian (author)
Univ Hosp Bonn, Dept Anesthesiol & Intens Care Med, Bonn, Germany.
Schmid, Werner (author)
Med Univ Vienna, Div Cardiac Thorac Vasc Anesthesia & Intens Care, Vienna, Austria.
Severgnini, Paolo (author)
Univ Insubria, Dept Biotechnol & Life, ASST Sette Laghi Osped Circolo & Fondazio Macchi, Varese, Italy.
Wrigge, Hermann (author)
Bermannstrost Hosp Halle, Dept Anaesthesiol Intens Care Med & Emergency Med, Pain Therapy, Halle, Germany.
de Abreu, Marcelo Gama (author)
Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Anesthesiol & Intens Care Med, Pulm Engn Grp, Dresden, Germany.;Cleveland Clin, Dept Intens Care & Resuscitat, Cleveland, OH 44106 USA.;Cleveland Clin, Dept Outcomes Res, Cleveland, OH 44106 USA.
Pelosi, Paolo (author)
Univ Genoa, Dept Surg Sci & Integrated Diagnost, Genoa, Italy.;San Martino Policlin Hosp, IRCCS Oncol & Neurosci, Anesthesia & Crit Care, Genoa, Italy.
Schultz, Marcus J. (author)
Locat AMC, Dept Intens Care, Amsterdam UMC, Amsterdam, Netherlands.;Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Bangkok, Thailand.;Univ Oxford, Nuffield Dept Med, Oxford, England.
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Locat AMC, Dept Anesthesiol, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands;Locat AMC, Dept Intens Care, Amsterdam UMC, Amsterdam, Netherlands. Locat AMC, Dept Intens Care, Amsterdam UMC, Amsterdam, Netherlands.;Monash Univ, Australian & New Zealand Intens Care Res Ctr ANZ, Dept Crit Care Med, Melbourne, Vic, Australia. (creator_code:org_t)
2022-01-07
2022
English.
In: BMC Anesthesiology. - : Springer Nature. - 1471-2253 .- 1471-2253. ; 22:1
Related links:
https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background: The aim of this analysis is to determine geo-economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods: Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle-income countries (LMIC and UMIC), and high-income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC); secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results: Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0-26.0] in LMIC, 16.0 [3.0-27.0] in UMIC and 15.0 [3.0-26.0] in HIC (P=.003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P <.001). Median tidal volume in ml kg(-1) predicted bodyweight (PBW) was 8.6 [7.7-9.7] in LMIC, 8.4 [7.6-9.5] in UMIC and 8.1 [7.2-9.1] in HIC (P<.001). Median positive end-expiratory pressure in cmH(2)O was 3.3 [2.0-5.0]) in LMIC, 4.0 [3.0-5.0] in UMIC and 5.0 [3.0-5.0] in HIC (P<.001). Median driving pressure in cmH(2)O was 14.0 [11.5-18.0] in LMIC, 13.5 [11.0-16.0] in UMIC and 12.0 [10.0-15.0] in HIC (P<.001). Median fraction of inspired oxygen in % was 75 [50-80] in LMIC, 50 [50-63] in UMIC and 53 [45-70] in HIC (P<.001). lntraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P<.001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P= .009). Conclusion: The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC.

Subject headings

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

Keyword

Geo-economic variation
Intraoperative ventilation
ARISCAT score
Postoperative pulmonary complications
ventilation
Ventilator management

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ref (subject category)
art (subject category)

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