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Sökning: WFRF:(Belda Francisco J.) > (2018) > Individualised peri...

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FältnamnIndikatorerMetadata
00009496naa a2200865 4500
001oai:DiVA.org:uu-350497
003SwePub
008180509s2018 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3504972 URI
0247 a https://doi.org/10.1016/S2213-2600(18)30024-92 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Ferrando, Carlosu Hosp Clin Univ, Dept Anesthesiol & Crit Care, Valencia 46010, Spain.;Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.4 aut
2451 0a Individualised perioperative open-lung approach versus standard protective ventilation in abdominal surgery (iPROVE) :b a randomised controlled trial
264 1b ELSEVIER SCI LTD,c 2018
338 a print2 rdacarrier
520 a Background The effects of individualised perioperative lung-protective ventilation (based on the open-lung approach [OLA]) on postoperative complications is unknown. We aimed to investigate the effects of intraoperative and postoperative ventilatory management in patients scheduled for abdominal surgery, compared with standard protective ventilation. Methods We did this prospective, multicentre, randomised controlled trial in 21 teaching hospitals in Spain. We enrolled patients who were aged 18 years or older, were scheduled to have abdominal surgery with an expected time of longer than 2 h, had intermediate-to-high-risk of developing postoperative pulmonary complications, and who had a body-mass index less than 35 kg/m(2). Patients were randomly assigned (1: 1: 1: 1) online to receive one of four lung-protective ventilation strategies using low tidal volume plus positive end-expiratory pressure (PEEP): open-lung approach (OLA)-iCPAP (individualised intraoperative ventilation [individualised PEEP after a lung recruitment manoeuvre] plus individualised postoperative continuous positive airway pressure [CPAP]), OLA-CPAP (intraoperative individualised ventilation plus postoperative CPAP), STD-CPAP (standard intraoperative ventilation plus postoperative CPAP), or STD-O-2 (standard intraoperative ventilation plus standard postoperative oxygen therapy). Patients were masked to treatment allocation. Investigators were not masked in the operating and postoperative rooms; after 24 h, data were given to a second investigator who was masked to allocations. The primary outcome was a composite of pulmonary and systemic complications during the first 7 postoperative days. We did the primary analysis using the modified intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT02158923. Findings Between Jan 2, 2015, and May 18, 2016, we enrolled 1012 eligible patients. Data were available for 967 patients, whom we included in the final analysis. Risk of pulmonary and systemic complications did not differ for patients in OLA-iCPAP (110 [46%] of 241, relative risk 0.89 [95% CI 0.74-1.07; p=0.25]), OLA-CPAP (111 [47%] of 238, 0.91 [0.76-1.09; p=0.35]), or STD-CPAP groups (118 [48%] of 244, 0.95 [0.80-1.14; p=0.65]) when compared with patients in the STD-O-2 group (125 [51%] of 244). Intraoperatively, PEEP was increased in 69 (14%) of patients in the standard perioperative ventilation groups because of hypoxaemia, and no patients from either of the OLA groups required rescue manoeuvres. Interpretation In patients who have major abdominal surgery, the different perioperative open lung approaches tested in this study did not reduce the risk of postoperative complications when compared with standard lung-protective mechanical ventilation.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Anestesi och intensivvård0 (SwePub)302012 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Anesthesiology and Intensive Care0 (SwePub)302012 hsv//eng
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Lungmedicin och allergi0 (SwePub)302192 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Respiratory Medicine and Allergy0 (SwePub)302192 hsv//eng
7001 a Soro, Marina4 aut
7001 a Unzueta, Carmenu Hosp Univ Sant Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.4 aut
7001 a Suarez-Sipmann, Fernandou Uppsala universitet,Hedenstiernalaboratoriet,Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.4 aut0 (Swepub:uu)fersi946
7001 a Canet, Jaumeu Hosp Univ Germans Tries & Pujol, Dept Anesthesiol & Crit Care, Badalona, Spain.4 aut
7001 a Librero, Julianu REDISSEC, Navarrabiomed Fdn Miguel Servet, Pamplona, Spain.4 aut
7001 a Pozo, Natividadu Hosp Clin Univ Valencia, INCLIVA Clin Res Inst, Valencia, Spain.4 aut
7001 a Peiro, Salvadoru REDISSEC, CSISP FISABIO, Valencia, Spain.4 aut
7001 a Llombart, Aliciau Hosp Univ Politecn Fe, IISLAFE Clin Res Inst, Valencia, Spain.4 aut
7001 a Leon, Ireneu Hosp Clin Univ, Dept Anesthesiol & Crit Care, Valencia 46010, Spain.4 aut
7001 a India, Inmaculadau Hosp Univ Sant Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.4 aut
7001 a Aldecoa, Cesaru Hosp Univ Rio Hortega, Dept Anesthesiol & Crit Care, Valladolid, Spain.4 aut
7001 a Diaz-Cambronero, Oscaru Hosp Univ Politecn Fe, Dept Anesthesiol & Crit Care, Valencia, Spain.4 aut
7001 a Pestana, Davidu Hosp Univ Ramon & Cajal, Dept Anesthesiol & Crit Care, Madrid, Spain.4 aut
7001 a Redondo, Francisco J.u Hosp Gen Univ Ciudad Real, Dept Anesthesiol & Crit Care, Ciudad Real, Spain.4 aut
7001 a Garutti, Ignaciou Hosp Gen Univ Gregorio Maranon, Dept Anesthesiol & Crit Care, Madrid, Spain.4 aut
7001 a Balust, Jaumeu Hosp Clin & Prov Univ, Dept Anesthesiol & Crit Care, Barcelona, Spain.4 aut
7001 a Garcia, Jose I.u Hosp Clin Univ, Dept Anesthesiol & Crit Care, Valencia 46010, Spain.;Hosp Univ Politecn Fe, Dept Anesthesiol & Crit Care, Valencia, Spain.;Hosp Fdn Alcorcon, Dept Anesthesiol & Crit Care, Alcorcon, Spain.;Hosp Univ Puerta Hierro, Dept Anesthesiol & Crit Care, Madrid, Spain.4 aut
7001 a Ibanez, Maiteu Hosp Marina Baixa Vila Joiosa, Dept Anesthesiol, Alicante, Spain.4 aut
7001 a Granell, Manuelu Hosp Gen Univ, Dept Anesthesiol & Crit Care, Valencia, Spain.4 aut
7001 a Rodriguez, Aureliou Hosp Univ Doctor Negrin, Dept Anesthesiol, Las Palmas Gran Canaria, Spain.4 aut
7001 a Gallego, Luciau Hosp Univ Miguel Servet, Dept Anesthesiol & Crit Care, Zaragoza, Spain.4 aut
7001 a de la Matta, Manuelu Hosp Univ Virgen Rocio, Dept Anesthesiol & Crit Care, Seville, Spain.4 aut
7001 a Gonzalez, Rafaelu Hosp Univ Leon, Dept Anesthesiol, Leon, Spain.4 aut
7001 a Brunelli, Andreau Hosp Univ Germans Tries & Pujol, Dept Anesthesiol & Crit Care, Badalona, Spain.4 aut
7001 a Garcia, Javier4 aut
7001 a Rovira, Lucasu Hosp Manises, Dept Anesthesiol, Valencia, Spain.4 aut
7001 a Barrios, Franciscou Hosp Principe Asturias Madrid, Dept Anesthesiol & Crit Care, Madrid, Spain.4 aut
7001 a Torres, Vicenteu Hosp Son Espases, Dept Anesthesiol & Crit Care, Palma de Mallorca, Spain.4 aut
7001 a Hernandez, Samuelu Hosp NS Candelaria, Dept Anesthesiol, Santa Cruz de Tenerife, Spain.4 aut
7001 a Gracia, Estefania4 aut
7001 a Gine, Martau Hosp Univ Sant Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.4 aut
7001 a Garcia, Mariau Hosp Univ Rio Hortega, Dept Anesthesiol & Crit Care, Valladolid, Spain.4 aut
7001 a Garcia, Nuria4 aut
7001 a Miguel, Lisset4 aut
7001 a Sanchez, Sergio4 aut
7001 a Pineiro, Patricia4 aut
7001 a Pujol, Rogeru Hosp Clin & Prov Univ, Dept Anesthesiol & Crit Care, Barcelona, Spain.4 aut
7001 a Garcia-del-Valle, Santiagou Hosp Fdn Alcorcon, Dept Anesthesiol & Crit Care, Alcorcon, Spain.4 aut
7001 a Valdivia, Joseu Hosp Marina Baixa Vila Joiosa, Dept Anesthesiol, Alicante, Spain.4 aut
7001 a Hernandez, Maria J.u Hosp Gen Univ, Dept Anesthesiol & Crit Care, Valencia, Spain.4 aut
7001 a Padron, Otou Hosp Univ Doctor Negrin, Dept Anesthesiol, Las Palmas Gran Canaria, Spain.4 aut
7001 a Colas, Anau Hosp Univ Miguel Servet, Dept Anesthesiol & Crit Care, Zaragoza, Spain.4 aut
7001 a Puig, Jaumeu Hosp Clin Univ, Dept Anesthesiol & Crit Care, Valencia 46010, Spain.4 aut
7001 a Azparren, Gonzalou Hosp Univ Sant Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.4 aut
7001 a Tusman, Gerardou Hosp Privado Comunidad Mar Plata, Dept Anesthesiol, Mar Del Plata, Buenos Aires, Argentina.4 aut
7001 a Villar, Jesusu Hosp Univ Doctor Negrin, Multidisciplinary Organ Dysfunct Evaluat Res Netw, Las Palmas Gran Canaria, Spain.4 aut
7001 a Belda, Javieru Hosp Clin Univ, Dept Anesthesiol & Crit Care, Valencia 46010, Spain.;Univ Valencia, Dept Surg, Valencia, Spain.4 aut
7102 a Hosp Clin Univ, Dept Anesthesiol & Crit Care, Valencia 46010, Spain.;Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.b Hosp Univ Sant Pau, Dept Anesthesiol & Crit Care, Barcelona, Spain.4 org
7730 t The Lancet Respiratory Medicined : ELSEVIER SCI LTDg 6:3, s. 193-203q 6:3<193-203x 2213-2600x 2213-2619
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-350497
8564 8u https://doi.org/10.1016/S2213-2600(18)30024-9

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