Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study
Abstract Background Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the ‘Multicentre Local ASsessment of VEntilatory m...
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BMC
2020-04-01
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| Series: | BMC Anesthesiology |
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| Online Access: | http://link.springer.com/article/10.1186/s12871-020-00988-x |
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| author | Chiara Robba Sabrine N. T. Hemmes Ary Serpa Neto Thomas Bluth Jaume Canet Michael Hiesmayr M. Wiersma Hollmann Gary H. Mills Marcos F. Vidal Melo Christian Putensen Samir Jaber Werner Schmid Paolo Severgnini Hermann Wrigge Denise Battaglini Lorenzo Ball Marcelo Gama de Abreu Marcus J. Schultz Paolo Pelosi FERS for the LAS VEGAS investigators the PROtective VEntilation Network and the Clinical Trial Network of the European Society of Anaesthesiology |
| author_facet | Chiara Robba Sabrine N. T. Hemmes Ary Serpa Neto Thomas Bluth Jaume Canet Michael Hiesmayr M. Wiersma Hollmann Gary H. Mills Marcos F. Vidal Melo Christian Putensen Samir Jaber Werner Schmid Paolo Severgnini Hermann Wrigge Denise Battaglini Lorenzo Ball Marcelo Gama de Abreu Marcus J. Schultz Paolo Pelosi FERS for the LAS VEGAS investigators the PROtective VEntilation Network and the Clinical Trial Network of the European Society of Anaesthesiology |
| author_sort | Chiara Robba |
| collection | DOAJ |
| description | Abstract Background Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the ‘Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3–9] per predicted body weight; median positive end–expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs. |
| first_indexed | 2024-12-21T18:43:05Z |
| format | Article |
| id | doaj.art-6730e57e993449929c2f248541cf2264 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-12-21T18:43:05Z |
| publishDate | 2020-04-01 |
| publisher | BMC |
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| series | BMC Anesthesiology |
| spelling | doaj.art-6730e57e993449929c2f248541cf22642022-12-21T18:53:58ZengBMCBMC Anesthesiology1471-22532020-04-0120111410.1186/s12871-020-00988-xIntraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS studyChiara Robba0Sabrine N. T. Hemmes1Ary Serpa Neto2Thomas Bluth3Jaume Canet4Michael Hiesmayr5M. Wiersma Hollmann6Gary H. Mills7Marcos F. Vidal Melo8Christian Putensen9Samir Jaber10Werner Schmid11Paolo Severgnini12Hermann Wrigge13Denise Battaglini14Lorenzo Ball15Marcelo Gama de Abreu16Marcus J. Schultz17Paolo Pelosi18FERS for the LAS VEGAS investigatorsthe PROtective VEntilation Network and the Clinical Trial Network of the European Society of AnaesthesiologyAnaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and NeurosciencesDepartment of Intensive Care, Amsterdam University Medical Centers, location ‘AMC’Department of Intensive Care, Amsterdam University Medical Centers, location ‘AMC’Department of Anaesthesiology and Intensive Care Medicine, Pulmonary engineering group, University Hospital Carl Gustav Carus, Technische Universitat DresdenDepartment of Anaesthesiology and Postoperative Care, Hospital Universitari Germans Trials I PujolDivision Cardiac, Thoracic, Vascular Anesthesia and Intensive Care, Medical University ViennaDepartment of Anaesthesiology, Amsterdam University Medical Centers, location ‘AMC’Operating Services, Critical Care and Anaesthesia, Sheffield Teaching Hospitals and University of SheffieldDepartment of Anaesthesia, Critical Care and Pain Medicine, Massachussetts General HospitalDepartment of Anesthesiology and Intenisve Care Medicine, University Hospital BonnDepartment of Anaesthesia and Intensive Care, Saint Eloi Montpellier University Hospital, and PhyMedExp, University of MontpellierDivision Cardiac, Thoracic, Vascular Anesthesia and Intensive Care, Medical University ViennaDepartment of Biotechnology and Sciences of Life, ASST-Setteleghi Ospedale di circolo e Fondazione Macchi, University of InsubriaDepartment of Anesthesiology and Intensive Care Medicine, University of LeipzigAnaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and NeurosciencesAnaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and NeurosciencesDepartment of Anaesthesiology and Intensive Care Medicine, Pulmonary engineering group, University Hospital Carl Gustav Carus, Technische Universitat DresdenDepartment of Intensive Care, Amsterdam University Medical Centers, location ‘AMC’Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and NeurosciencesAbstract Background Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the ‘Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3–9] per predicted body weight; median positive end–expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.http://link.springer.com/article/10.1186/s12871-020-00988-xLAS VEGASMechanical ventilationPostoperative pulmonary complicationsNeurosurgery |
| spellingShingle | Chiara Robba Sabrine N. T. Hemmes Ary Serpa Neto Thomas Bluth Jaume Canet Michael Hiesmayr M. Wiersma Hollmann Gary H. Mills Marcos F. Vidal Melo Christian Putensen Samir Jaber Werner Schmid Paolo Severgnini Hermann Wrigge Denise Battaglini Lorenzo Ball Marcelo Gama de Abreu Marcus J. Schultz Paolo Pelosi FERS for the LAS VEGAS investigators the PROtective VEntilation Network and the Clinical Trial Network of the European Society of Anaesthesiology Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study BMC Anesthesiology LAS VEGAS Mechanical ventilation Postoperative pulmonary complications Neurosurgery |
| title | Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study |
| title_full | Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study |
| title_fullStr | Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study |
| title_full_unstemmed | Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study |
| title_short | Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study |
| title_sort | intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients post hoc analysis of las vegas study |
| topic | LAS VEGAS Mechanical ventilation Postoperative pulmonary complications Neurosurgery |
| url | http://link.springer.com/article/10.1186/s12871-020-00988-x |
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