Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries
Abstract Background The aim of this analysis is to determine geo–economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle–income countries (LMIC and...
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| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-021-01560-x |
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| author | Liselotte Hol Sunny G. L. H. Nijbroek Ary Serpa Neto Sabrine N. T. Hemmes Goran Hedenstierna Michael Hiesmayr Markus W. Hollmann Gary H. Mills Marcos F. Vidal Melo Christian Putensen Werner Schmid Paolo Severgnini Hermann Wrigge Marcelo Gama de Abreu Paolo Pelosi Marcus J. Schultz for the LAS VEGAS study–investigators |
| author_facet | Liselotte Hol Sunny G. L. H. Nijbroek Ary Serpa Neto Sabrine N. T. Hemmes Goran Hedenstierna Michael Hiesmayr Markus W. Hollmann Gary H. Mills Marcos F. Vidal Melo Christian Putensen Werner Schmid Paolo Severgnini Hermann Wrigge Marcelo Gama de Abreu Paolo Pelosi Marcus J. Schultz for the LAS VEGAS study–investigators |
| author_sort | Liselotte Hol |
| collection | DOAJ |
| description | Abstract Background The aim of this analysis is to determine geo–economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle–income countries (LMIC and UMIC), and high–income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC); secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0–26.0] in LMIC, 16.0 [3.0–27.0] in UMIC and 15.0 [3.0–26.0] in HIC (P = .003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P < .001). Median tidal volume in ml kg− 1 predicted bodyweight (PBW) was 8.6 [7.7–9.7] in LMIC, 8.4 [7.6–9.5] in UMIC and 8.1 [7.2–9.1] in HIC (P < .001). Median positive end–expiratory pressure in cmH2O was 3.3 [2.0–5.0]) in LMIC, 4.0 [3.0–5.0] in UMIC and 5.0 [3.0–5.0] in HIC (P < .001). Median driving pressure in cmH2O was 14.0 [11.5–18.0] in LMIC, 13.5 [11.0–16.0] in UMIC and 12.0 [10.0–15.0] in HIC (P < .001). Median fraction of inspired oxygen in % was 75 [50–80] in LMIC, 50 [50–63] in UMIC and 53 [45–70] in HIC (P < .001). Intraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P < .001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P = .009). Conclusion The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC. Trial registration Clinicaltrials.gov , identifier: NCT01601223. |
| first_indexed | 2024-12-18T04:17:42Z |
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| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-18T04:17:42Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj.art-301ed13ab7f04c07b338082220b13d282022-12-21T21:21:19ZengBMCBMC Anesthesiology1471-22532022-01-0122111110.1186/s12871-021-01560-xGeo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countriesLiselotte Hol0Sunny G. L. H. Nijbroek1Ary Serpa Neto2Sabrine N. T. Hemmes3Goran Hedenstierna4Michael Hiesmayr5Markus W. Hollmann6Gary H. Mills7Marcos F. Vidal Melo8Christian Putensen9Werner Schmid10Paolo Severgnini11Hermann Wrigge12Marcelo Gama de Abreu13Paolo Pelosi14Marcus J. Schultz15for the LAS VEGAS study–investigatorsDepartment of Anesthesiology, Amsterdam UMC, location AMCDepartment of Anesthesiology, Amsterdam UMC, location AMCDepartment of Intensive Care, Amsterdam UMC, location AMCDepartment of Anesthesiology, Amsterdam UMC, location AMCDepartment of Medical Sciences, Clinical Physiology, Uppsala UniversityDivision Cardiac, Thoracic, Vascular Anesthesia and Intensive Care, Medical University ViennaDepartment of Anesthesiology, Amsterdam UMC, location AMCOperating Services, Critical Care and Anaesthesia, Sheffield Teaching Hospitals, Sheffield and University of SheffieldDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General HospitalDepartment of Anesthesiology and Intensive Care Medicine, University Hospital BonnDivision Cardiac, Thoracic, Vascular Anesthesia and Intensive Care, Medical University ViennaDepartment of Biotechnology and Life, ASST Sette Laghi Ospedale di Circolo e Fondazio Macchi, University of InsubriaDepartment of Anaesthesiology, Intensive Care Medicine and Emergency Medicine, Pain Therapy, Bermannstrost Hospital HalleDepartment of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus, Technical University DresdenDepartment of Surgical Sciences and Integrated Diagnostics, Università degli Studi di GenovaDepartment of Intensive Care, Amsterdam UMC, location AMCAbstract Background The aim of this analysis is to determine geo–economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle–income countries (LMIC and UMIC), and high–income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC); secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0–26.0] in LMIC, 16.0 [3.0–27.0] in UMIC and 15.0 [3.0–26.0] in HIC (P = .003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P < .001). Median tidal volume in ml kg− 1 predicted bodyweight (PBW) was 8.6 [7.7–9.7] in LMIC, 8.4 [7.6–9.5] in UMIC and 8.1 [7.2–9.1] in HIC (P < .001). Median positive end–expiratory pressure in cmH2O was 3.3 [2.0–5.0]) in LMIC, 4.0 [3.0–5.0] in UMIC and 5.0 [3.0–5.0] in HIC (P < .001). Median driving pressure in cmH2O was 14.0 [11.5–18.0] in LMIC, 13.5 [11.0–16.0] in UMIC and 12.0 [10.0–15.0] in HIC (P < .001). Median fraction of inspired oxygen in % was 75 [50–80] in LMIC, 50 [50–63] in UMIC and 53 [45–70] in HIC (P < .001). Intraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P < .001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P = .009). Conclusion The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC. Trial registration Clinicaltrials.gov , identifier: NCT01601223.https://doi.org/10.1186/s12871-021-01560-xGeo–economic variationIntraoperative ventilationARISCAT scorePostoperative pulmonary complications, ventilation, intraoperative ventilationVentilator management |
| spellingShingle | Liselotte Hol Sunny G. L. H. Nijbroek Ary Serpa Neto Sabrine N. T. Hemmes Goran Hedenstierna Michael Hiesmayr Markus W. Hollmann Gary H. Mills Marcos F. Vidal Melo Christian Putensen Werner Schmid Paolo Severgnini Hermann Wrigge Marcelo Gama de Abreu Paolo Pelosi Marcus J. Schultz for the LAS VEGAS study–investigators Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries BMC Anesthesiology Geo–economic variation Intraoperative ventilation ARISCAT score Postoperative pulmonary complications, ventilation, intraoperative ventilation Ventilator management |
| title | Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries |
| title_full | Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries |
| title_fullStr | Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries |
| title_full_unstemmed | Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries |
| title_short | Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries |
| title_sort | geo economic variations in epidemiology ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia posthoc analysis of an observational study in 29 countries |
| topic | Geo–economic variation Intraoperative ventilation ARISCAT score Postoperative pulmonary complications, ventilation, intraoperative ventilation Ventilator management |
| url | https://doi.org/10.1186/s12871-021-01560-x |
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