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Individualised, per...
Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV) : a multicentre, randomised, controlled clinical trial
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- Ferrando, Carlos (författare)
- Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain.;Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.;Inst Invest August Pi & Sunyer, Hosp Clin, Dept Anesthesiol & Crit Care, Barcelona 08036, Spain.
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- Carraminana, Albert (författare)
- Hosp Clin Barcelona, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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Pineiro, Patricia (författare)
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visa fler...
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- Mirabella, Lucia (författare)
- Univ Foggia, Dept Med & Surg Sci, Foggia, Italy.
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- Spadaro, Savino (författare)
- Azienda Osped Univ Ferrara, Dept Anesthesiol & Crit Care, I-44100 Ferrara, Italy.
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- Libero, Julian (författare)
- Navarrabiomed CHN UPNA, Red Invest Serv Sanitarios & Cronicidad REDISSEC, IdiSNA, Pamplona, Spain.
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- Ramasco, Fernando (författare)
- Hosp Univ Princesa, Dept Anesthesiol & Crit Care, Madrid, Spain.
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- Scaramuzzo, Gaetano (författare)
- Azienda Osped Univ Ferrara, Dept Anesthesiol & Crit Care, I-44100 Ferrara, Italy.
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- Cervantes, Oriol (författare)
- Hosp Badalona Germans Trias & Pujol, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Garutti, Ignacio (författare)
- Hosp Univ Gregorio Maranon, Dept Anesthesiol & Crit Care, Madrid, Spain.
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- Parera, Ana (författare)
- Hosp Univ St Creu & St Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Argilaga, Marta (författare)
- Hosp Univ St Creu & St Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Herranz, Gracia (författare)
- Hosp Univ St Creu & St Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Unzueta, Carmen (författare)
- Hosp Univ St Creu & St Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Vives, Marc (författare)
- Hosp Univ Josep Trueta, Dept Anesthesiol & Crit Care, Girona, Spain.
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- Regi, Kevin (författare)
- Hosp Univ Josep Trueta, Dept Anesthesiol & Crit Care, Girona, Spain.
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- Costa-Reverte, Marta (författare)
- Hosp Univ Bellvitge, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Leal, Maria Sonsoles (författare)
- Hosp Rivera Povisa, Vigo, Spain.
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Garcia, Esther (författare)
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- Rodriguez-Perez, Aurelio (författare)
- Hosp Univ Gran Canaria Dr Negrin, Dept Anesthesiol & Crit Care, Gran Canarias, Spain.
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- Farina, Roberto (författare)
- Hosp Univ Gran Canaria Dr Negrin, Dept Anesthesiol & Crit Care, Gran Canarias, Spain.
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- Cabrera, Sergio (författare)
- Hosp Univ Gran Canaria Dr Negrin, Dept Anesthesiol & Crit Care, Gran Canarias, Spain.
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- Guerra, Elisabeth (författare)
- Hosp Univ Princesa, Dept Anesthesiol & Crit Care, Madrid, Spain.;Hosp Univ Gran Canaria Dr Negrin, Dept Anesthesiol & Crit Care, Gran Canarias, Spain.
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- Gallego-Ligorit, Lucia (författare)
- Hosp Univ Miguel Servet, Dept Anesthesiol & Crit Care, Zaragoza, Spain.;Inst Invest Sanitaria Aragon IIS Aragon, Zaragoza, Spain.
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- Herrero-Izquierdo, Alba (författare)
- Hosp Univ Miguel Servet, Dept Anesthesiol & Crit Care, Zaragoza, Spain.;Inst Invest Sanitaria Aragon IIS Aragon, Zaragoza, Spain.
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- Valles-Torres, J. (författare)
- Hosp Univ Miguel Servet, Dept Anesthesiol & Crit Care, Zaragoza, Spain.;Inst Invest Sanitaria Aragon IIS Aragon, Zaragoza, Spain.
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- Ramos, Silvia (författare)
- Hosp Univ Gregorio Maranon, Dept Anesthesiol & Crit Care, Madrid, Spain.
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- Lopez-Herrera, Daniel (författare)
- Hosp Univ Virgen Rocio, Dept Anesthesiol & Crit Care, Seville, Spain.
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- Matta, Manuel De La (författare)
- Hosp Univ Virgen Rocio, Dept Anesthesiol & Crit Care, Seville, Spain.
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- Gokhan, Sertcakacilar (författare)
- Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Anesthesiol & Crit Care, Istanbul, Turkiye.;Outcomes Res Consortium, Cleveland, OH USA.
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- Kucur, Evrim (författare)
- Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Anesthesiol & Crit Care, Istanbul, Turkiye.
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- Mugarra, Ana (författare)
- Hosp Clin Univ Valencia, Dept Anesthesiol & Crit Care, Valencia, Spain.
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- Soro, Marina (författare)
- Hosp Clin Univ Valencia, Dept Anesthesiol & Crit Care, Valencia, Spain.
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- Garcia, Laura (författare)
- Hosp Clin Univ Valencia, Dept Anesthesiol & Crit Care, Valencia, Spain.
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- Sastre, Jose Alfonso (författare)
- Hosp Univ Salamanca, Dept Anesthesiol & Crit Care, Salamanca 37007, Spain.
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- Aguirre, Pilar (författare)
- Hosp Alvaro Cunqueiro, Dept Anesthesiol & Crit Care, Vigo, Spain.
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- Salazar, Claudia Jimena (författare)
- Hosp Univ Ntra Sra Candelaria, Dept Syst Anesthesiol & Crit Care, Santa Cruz De Tenerife, Spain.
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- Ramos, Maria Carolina (författare)
- Hosp Univ Ntra Sra Candelaria, Dept Syst Anesthesiol & Crit Care, Santa Cruz De Tenerife, Spain.
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- Morocho, Diego Rolando (författare)
- Hosp Eugenio Espejo, Dept Anesthesiol, Quito, Ecuador.
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- Trespalacios, Ramon (författare)
- Hosp Univ Cent Asturias, Dept Anesthesiol & Crit Care, Oviedo, Spain.
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- Ezequiel-Fernandez, Felix (författare)
- Hosp Univ Cent Asturias, Dept Anesthesiol & Crit Care, Oviedo, Spain.
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- Lamanna, Angella (författare)
- Univ Foggia, Dept Med & Surg Sci, Foggia, Italy.
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- Cantatore, Leonarda Pia (författare)
- Univ Foggia, Dept Med & Surg Sci, Foggia, Italy.
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- Laforgia, Donato (författare)
- Univ Foggia, Dept Med & Surg Sci, Foggia, Italy.
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- Bellas, Soledad (författare)
- Hosp Univ Fdn Jimenez Diaz, Dept Anesthesiol & Crit Care, Madrid, Spain.
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- Lopez, Carlos (författare)
- Hosp Univ Marques de Valdecilla, Dept Anesthesiol & Crit Care, Santander, Spain.
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- Navarro-Ripoll, Ricard (författare)
- Hosp Clin Barcelona, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Martinez, Samira (författare)
- Hosp Clin Barcelona, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Vallverdu, Jordi (författare)
- Hosp Clin Barcelona, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Jacas, Adriana (författare)
- Hosp Clin Barcelona, Dept Anesthesiol & Crit Care, Barcelona, Spain.
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- Yepes-Temino, Maria Jose (författare)
- Clin Univ Navarra, Dept Anesthesiol & Crit Care, Pamplona, Spain.
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Belda, Francisco Javier (författare)
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- Tusman, Gerardo (författare)
- Hosp Privado Comunidad Mar Del Plata, Dept Anestesiol, Mar Del Plata, Buenos Aires, Argentina.
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- Suarez-Sipmann, Fernando (författare)
- Uppsala universitet,Hedenstiernalaboratoriet,Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain.
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- Villar, Jesus (författare)
- CIBER Enfermedades Resp, Madrid, Spain.;Hosp Univ Dr Negrin, Las Palmas Gran Canaria, Spain.;St Michaels Hosp, Li Ka Shing Knowledge Inst Med Sci, Toronto, ON, Canada.
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Inst Invest Biomed August Pi & Sunyer, Barcelona, Spain;Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.;Inst Invest August Pi & Sunyer, Hosp Clin, Dept Anesthesiol & Crit Care, Barcelona 08036, Spain. Hosp Clin Barcelona, Dept Anesthesiol & Crit Care, Barcelona, Spain. (creator_code:org_t)
- Elsevier, 2024
- 2024
- Engelska.
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Ingår i: The Lancet Respiratory Medicine. - : Elsevier. - 2213-2600 .- 2213-2619. ; 12:3, s. 195-206
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background It is uncertain whether individualisation of the perioperative open-lung approach (OLA) to ventilation reduces postoperative pulmonary complications in patients undergoing lung resection. We compared a perioperative individualised OLA (iOLA) ventilation strategy with standard lung-protective ventilation in patients undergoing thoracic surgery with one-lung ventilation. Methods This multicentre, randomised controlled trial enrolled patients scheduled for open or video-assisted thoracic surgery using one-lung ventilation in 25 participating hospitals in Spain, Italy, Turkey, Egypt, and Ecuador. Eligible adult patients (age >= 18 years) were randomly assigned to receive iOLA or standard lung-protective ventilation. Eligible patients (stratified by centre) were randomly assigned online by local principal investigators, with an allocation ratio of 1:1. Treatment with iOLA included an alveolar recruitment manoeuvre to 40 cm H2O of end-inspiratory pressure followed by individualised positive end-expiratory pressure (PEEP) titrated to best respiratory system compliance, and individualised postoperative respiratory support with high-flow oxygen therapy. Participants allocated to standard lungprotective ventilation received combined intraoperative 4 cm H2O of PEEP and postoperative conventional oxygen therapy. The primary outcome was a composite of severe postoperative pulmonary complications within the first 7 postoperative days, including atelectasis requiring bronchoscopy, severe respiratory failure, contralateral pneumothorax, early extubation failure (rescue with continuous positive airway pressure, non-invasive ventilation, invasive mechanical ventilation, or reintubation), acute respiratory distress syndrome, pulmonary infection, bronchopleural fistula, and pleural empyema. Due to trial setting, data obtained in the operating and postoperative rooms for routine monitoring were not blinded. At 24 h, data were acquired by an investigator blinded to group allocation. All analyses were performed on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, NCT03182062, and is complete. Findings Between Sept 11, 2018, and June 14, 2022, we enrolled 1380 patients, of whom 1308 eligible patients (670 [434 male, 233 female, and three with missing data] assigned to iOLA and 638 [395 male, 237 female, and six with missing data] to standard lung-protective ventilation) were included in the final analysis. The proportion of patients with the composite outcome of severe postoperative pulmonary complications within the first 7 postoperative days was lower in the iOLA group compared with the standard lung-protective ventilation group (40 [6%] vs 97 [15%], relative risk 0 center dot 39 [95% CI 0 center dot 28 to 0 center dot 56]), with an absolute risk difference of -9 center dot 23 (95% CI -12 center dot 55 to -5 center dot 92). Recruitment manoeuvre-related adverse events were reported in five patients. Interpretation Among patients subjected to lung resection under one-lung ventilation, iOLA was associated with a reduced risk of severe postoperative pulmonary complications when compared with conventional lung-protective ventilation. Funding Instituto de Salud Carlos III and the European Regional Development Funds. Copyright (c) 2023 Elsevier Ltd. All rights reserved.
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 -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
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Ferrando, Carlos
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Carraminana, Alb ...
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Pineiro, Patrici ...
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Mirabella, Lucia
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Spadaro, Savino
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Libero, Julian
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Ramasco, Fernand ...
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Scaramuzzo, Gaet ...
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Cervantes, Oriol
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Garutti, Ignacio
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Parera, Ana
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Argilaga, Marta
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Herranz, Gracia
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Unzueta, Carmen
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Vives, Marc
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Regi, Kevin
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Costa-Reverte, M ...
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Leal, Maria Sons ...
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Garcia, Esther
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Rodriguez-Perez, ...
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Farina, Roberto
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Cabrera, Sergio
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Guerra, Elisabet ...
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Gallego-Ligorit, ...
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Herrero-Izquierd ...
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Valles-Torres, J ...
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Ramos, Silvia
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Lopez-Herrera, D ...
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Matta, Manuel De ...
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Gokhan, Sertcaka ...
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Kucur, Evrim
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Mugarra, Ana
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Soro, Marina
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Garcia, Laura
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Sastre, Jose Alf ...
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Aguirre, Pilar
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Salazar, Claudia ...
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Ramos, Maria Car ...
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Morocho, Diego R ...
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Trespalacios, Ra ...
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Ezequiel-Fernand ...
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Lamanna, Angella
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Cantatore, Leona ...
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Laforgia, Donato
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Bellas, Soledad
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Lopez, Carlos
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Navarro-Ripoll, ...
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Martinez, Samira
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Vallverdu, Jordi
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Jacas, Adriana
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Yepes-Temino, Ma ...
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Belda, Francisco ...
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Tusman, Gerardo
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Suarez-Sipmann, ...
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Villar, Jesus
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Pediatrik
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