Intraoperative ventilation settings and their associations with postoperative pulmonary complications in obese patients

British Journal of Anaesthesia
Lorenzo BallClinical Trial Network of the European Society of Anaesthesiology

Abstract

There is limited information concerning the current practice of intraoperative mechanical ventilation in obese patients, and the optimal ventilator settings for these patients are debated. We investigated intraoperative ventilation parameters and their associations with the development of postoperative pulmonary complications (PPCs) in obese patients. We performed a secondary analysis of the international multicentre Local ASsessment of VEntilatory management during General Anesthesia for Surgery' (LAS VEGAS) study, restricted to obese patients, with a predefined composite outcome of PPCs as primary end-point. We analysed 2012 obese patients from 135 hospitals across 29 countries in Europe, North America, North Africa, and the Middle East. Tidal volume was 8.8 [25th-75th percentiles: 7.8-9.9] ml kg-1 predicted body weight, PEEP was 4 [1-5] cm H2O, and recruitment manoeuvres were performed in 7.7% of patients. PPCs occurred in 11.7% of patients and were independently associated with age (P<0.001), body mass index ≥40 kg m-2 (P=0.033), obstructive sleep apnoea (P=0.002), duration of anaesthesia (P<0.001), peak airway pressure (P<0.001), use of rescue recruitment manoeuvres (P<0.05) and routine recruitment manoeuvres performed by ...Continue Reading

Citations

Mar 29, 2019·Expert Review of Respiratory Medicine·Giulia BonattiPaolo Pelosi
Jun 4, 2019·JAMA : the Journal of the American Medical Association·UNKNOWN Writing Committee for the PROBESE Collaborative Group of the PROtective VEntilation Network (PROVEnet) for the Clinical TriaMarcelo Gama de Abreu
Jun 4, 2019·JAMA : the Journal of the American Medical Association·Thomas Godet, Emmanuel Futier
Oct 20, 2019·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·Gyorgy B HalmosJan E Wachters
May 15, 2020·International Anesthesiology Clinics·Luiz F D R FalcãoMarcelo Gama de Abreu
Mar 19, 2019·Anesthesiology·Domenico Luca GriecoMassimo Antonelli
Jan 7, 2020·The British Journal of Surgery·M CarronM Foletto
Mar 20, 2019·Intensive Care Medicine·Miet SchetzSamir Jaber
Apr 22, 2020·Anaesthesia·N H Sperna WeilandUNKNOWN contributors
May 18, 2019·Critical Care : the Official Journal of the Critical Care Forum·Lorenzo Ball, Paolo Pelosi
Jul 24, 2020·BMC Anesthesiology·Christopher UhligUNKNOWN LAS VEGAS# investigators, Protective Ventilation Network (PROVEnet), Clinical Trial Network of the European Society of Anaes
Oct 24, 2020·Intensive Care Medicine·Audrey De JongSamir Jaber
Sep 11, 2019·Current Opinion in Anaesthesiology·James TankelSharon Einav
Feb 19, 2020·Anaesthesia Critical Care & Pain Medicine·Audrey De JongSamir Jaber
Apr 13, 2021·Anesthesiology·Philipp SimonUNKNOWN PROBESE Investigators of the Protective Ventilation Network* and the Clinical Trial Network of the European Society of Anest
Oct 6, 2019·Anaesthesia Critical Care & Pain Medicine·Thomas GodetEmmanuel Futier
May 27, 2021·Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS·Hermann Wrigge, Fridolin Streibert
Jun 7, 2021·Advances in Therapy·Andrea P HarenPasquale Sansone
Aug 19, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Lorenzo BallElena Bignami

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