Low Tidal Volume Mechanical Ventilation Against No Ventilation During Cardiopulmonary Bypass in Heart Surgery (MECANO): A Randomized Controlled Trial.

Chest
Lee S NguyenPierre Squara

Abstract

Postoperative pulmonary complications are common after cardiac surgery and have been related to lung collapse during cardiopulmonary bypass (CPB). No consensus exists regarding the effects of maintaining mechanical ventilation during CPB to decrease these complications. To determine whether maintaining low-tidal ventilation (3 mL/kg 5 times/min, with positive end expiratory pressure of 5 cm H2O) during CPB (ventilation strategy) was superior to a resting-lung strategy with no ventilation (no ventilation strategy) regarding postoperative pulmonary complications, including mortality. In a randomized controlled trial, patients undergoing cardiac surgery at a single center from May 2017 through August 2019 were randomized to the ventilation or no ventilation strategy during CPB (1:1 ratio). Apart from the CPB phase, perioperative ventilation procedures were standardized. The study included 1,501 patients (mean age, 68.8 ± 10.3 years; 1,152 (76.7%) men; mean EuroSCORE II, 2.3 ± 2.7). Seven hundred fifty-six patients were in the ventilation strategy group, and no differences existed in baseline characteristics and types of procedures between the two groups. An intention-to-treat analysis yielded no significant difference between the ...Continue Reading

References

Jul 9, 2003·Critical Care Medicine·Emilio BouzaUNKNOWN Cardiovascular Infection Study Group
Dec 25, 2007·The Annals of Thoracic Surgery·Calvin S H NgAnthony P C Yim
Nov 4, 2010·Anesthesiology·Jaume CanetUNKNOWN ARISCAT Group
Aug 2, 2013·The New England Journal of Medicine·Emmanuel FutierUNKNOWN IMPROVE Study Group
Mar 1, 2014·Journal of Intensive Care Medicine·J IbañezO Bonnin
Jul 17, 2014·Critical Care : the Official Journal of the Critical Care Forum·Silvia CoppolaDavide Chiumello
Nov 12, 2015·Indian Journal of Anaesthesia·Kalpana Vinod Kelkar
Jul 30, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Elena BignamiOttavio Alfieri
Mar 23, 2017·JAMA : the Journal of the American Medical Association·Alcino Costa LemeMarcelo Britto Passos Amato
Mar 14, 2018·The Journal of Thoracic and Cardiovascular Surgery·Lee S NguyenPierre Squara
Nov 22, 2018·Annals of Translational Medicine·Elena BignamiAntonio Di Lullo

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