Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations

British Journal of Anaesthesia
Christopher C YoungJ Sprung

Abstract

Postoperative pulmonary complications (PPCs) occur frequently and are associated with substantial morbidity and mortality. Evidence suggests that reduction of PPCs can be accomplished by using lung-protective ventilation strategies intraoperatively, but a consensus on perioperative management has not been established. We sought to determine recommendations for lung protection for the surgical patient at an international consensus development conference. Seven experts produced 24 questions concerning preoperative assessment and intraoperative mechanical ventilation for patients at risk of developing PPCs. Six researchers assessed the literature using questions as a framework for their review. The modified Delphi method was utilised by a team of experts to produce recommendations and statements from study questions. An expert consensus was reached for 22 recommendations and four statements. The following are the highlights: (i) a dedicated score should be used for preoperative pulmonary risk evaluation; and (ii) an individualised mechanical ventilation may improve the mechanics of breathing and respiratory function, and prevent PPCs. The ventilator should initially be set to a tidal volume of 6-8 ml kg-1 predicted body weight and...Continue Reading

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Citations

Feb 3, 2020·Korean journal of anesthesiology·Mikhail Y Kirov, Vsevolod V Kuzkov
Jun 6, 2020·Paediatric Anaesthesia·Marion LebosséUNKNOWN ADARPEF (Association Des Anesthésistes Réanimateurs Pédiatriques d'Expression Française)
May 15, 2020·International Anesthesiology Clinics·Luiz F D R FalcãoMarcelo Gama de Abreu
Sep 25, 2020·Anesthesiology·Marcelo Gama de AbreuPaolo Pelosi
Aug 21, 2020·Journal of Clinical Monitoring and Computing·Savino SpadaroAlberto Fogagnolo
Jul 24, 2020·BMC Anesthesiology·Christopher UhligUNKNOWN LAS VEGAS# investigators, Protective Ventilation Network (PROVEnet), Clinical Trial Network of the European Society of Anaes
Sep 10, 2020·Current Anesthesiology Reports·Zyad J CarrKunal Karamchandani
Oct 2, 2020·Current Opinion in Anaesthesiology·Girish P Joshi
Jan 26, 2021·Anaesthesia Critical Care & Pain Medicine·David Lagier, Marcos F Vidal Melo
Jul 1, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Daniel S CormicanHarish Ramakrishna
Nov 3, 2020·British Journal of Anaesthesia·UNKNOWN Assessment of Ventilation during general AnesThesia for Robotic surgery (AVATaR) Study InvestigatorsUNKNOWN AVATaR Investigators
Nov 14, 2020·Anesthesia and Analgesia·Lorenzo BallPaolo Pelosi
Jan 10, 2021·The Journal of Thoracic and Cardiovascular Surgery·Andrea MontisciAntonio Miceli
Apr 13, 2021·Anesthesiology·Philipp SimonUNKNOWN PROBESE Investigators of the Protective Ventilation Network* and the Clinical Trial Network of the European Society of Anest
Apr 15, 2021·Annals of Intensive Care·Jean-Luc FellahiDan Longrois
Apr 25, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Giovanni LandoniLuca Cabrini
May 4, 2021·Current Opinion in Anaesthesiology·Mary Yurashevich, Ashraf S Habib
May 11, 2021·European Journal of Anaesthesiology·Chahyun OhBoohwi Hong
Feb 17, 2021·Minerva anestesiologica·Claudia CarielloFrancesco Forfori
Feb 20, 2021·European Journal of Anaesthesiology·Sunny G NijbroekUNKNOWN LAS VEGAS study investigators, the PROVE Network and the Clinical Trial Network of the European Society of Anaesthesiology
Aug 31, 2021·Acta Anaesthesiologica Scandinavica·Carlos FerrandoUNKNOWN iPROVE Network Group

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