0000000000306241

AUTHOR

Rolf Rossaint

showing 9 related works from this author

Individualized versus fixed positive end-expiratory pressure for intraoperative mechanical ventilation in obese patients: a secondary analysis

2021

Background General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP. Methods This secondary analysis included all obese patients recruited at University Hospital of Leipzig from the multicenter Protective Intraoperative Ventilation with Higher versus Lower Levels of Positive End-Expiratory Pressure in Obese Patients (PROBESE) trial (n = 42) and likewise all obese patients from a local single-center trial (n = 54). Inclusion criteria for both trials were elective laparoscopic abdominal…

Pulmonary Atelectasismedicine.medical_treatment[SDV]Life Sciences [q-bio]AtelectasisPositive-Pressure Respiration03 medical and health sciences0302 clinical medicine030202 anesthesiologyInterquartile rangemedicineTidal VolumeHumansObesity10. No inequalityPEEPPositive end-expiratory pressureTidal volumeComputingMilieux_MISCELLANEOUS2. Zero hungerMechanical ventilationbusiness.industryRespirationEnvironmental air flowOxygenationrespiratory systemmedicine.disease3. Good healthrespiratory tract diseasesAnesthesiology and Pain MedicineAnesthesiaArtificialBreathingbusinesstherapeutics030217 neurology & neurosurgeryHumans; Obesity; Positive-Pressure Respiration; Pulmonary Atelectasis; Respiration Artificial; Tidal Volumecirculatory and respiratory physiology
researchProduct

Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical…

2022

BACKGROUND: High intraoperative PEEP with recruitment manoeuvres may improve perioperative outcomes. We re-examined this question by conducting a patient-level meta-analysis of three clinical trials in adult patients at increased risk for postoperative pulmonary complications who underwent non-cardiothoracic and non-neurological surgery. METHODS: The three trials enrolled patients at 128 hospitals in 24 countries from February 2011 to February 2018. All patients received volume-controlled ventilation with low tidal volume. Analyses were performed using one-stage, two-level, mixed modelling (site as a random effect; trial as a fixed effect). The primary outcome was a composite of postoperati…

AdultLung Diseases*PEEP*postoperative pulmonary complicationsmechanical ventilationPositive-Pressure RespirationsurgeryAnesthesiology and Pain MedicinePostoperative ComplicationsTidal Volume*surgeryHumanspostoperative pulmonary complicationsPostoperative Period*mechanical ventilationmechanical ventilation; PEEP; postoperative pulmonary complications; surgery; Adult; Humans; Lung; Postoperative Complications; Postoperative Period; Randomized Controlled Trials as Topic; Tidal Volume; Lung Diseases; Positive-Pressure RespirationLungPEEPRandomized Controlled Trials as Topic
researchProduct

Correction to: Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR…

2019

Background Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. Methods PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two differe…

medicine.medical_specialtyone-lung ventilationMedicine (miscellaneous)recruitment maneuverVentilaciólaw.invention03 medical and health sciencesStudy Protocol0302 clinical medicineMechanical ventilationRandomized controlled triallawmedicinePharmacology (medical)030212 general & internal medicinePositive end-expiratory pressureTòrax2. Zero hungerProtocol (science)lcsh:R5-920Cirurgiabusiness.industryrespiratory systemOne lung ventilationthoracic surgery3. Good healthrespiratory tract diseasesProtective ventilationCardiothoracic surgeryAnesthesiapostoperative pulmonary complicationlcsh:Medicine (General)business030217 neurology & neurosurgerypositive end-expiratory pressure
researchProduct

Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

2022

PLOS ONE 17(1), e0262110 (2022). doi:10.1371/journal.pone.0262110

Clinical OncologyMaleScienceClinical Decision-MakingCancer TreatmentSurgical and Invasive Medical ProceduresGeographical LocationsDiagnostic MedicineOutcome Assessment Health CareMedicine and Health SciencesHumansBlood TransfusionProspective StudiesAgedAged 80 and overIntraoperative CareMultidisciplinaryTransfusion MedicineQRAnemiaHematologyClinical Laboratory SciencesHealth CareEuropeSurgical OncologyOncologyAge GroupsElective Surgical ProceduresPeople and PlacesMedicinePopulation GroupingsFemaleGeriatric CareClinical MedicineErythrocyte TransfusionResearch ArticlePLOS ONE
researchProduct

Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease

2021

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need fo…

Malemedicine.medical_treatmentpulmonary complicationsRESPIRATORY-DISTRESS-SYNDROMECritical Care and Intensive Care MedicineCASE-FATALITY0302 clinical medicineRisk FactorsBrain Injuries TraumaticMulticenter Studies as TopicHospital MortalityProspective StudiesSimplified Acute Physiology ScoreStrokePOPULATIONSimplified Acute Physiology ScoreAge FactorsANEURYSMAL SUBARACHNOID HEMORRHAGEMiddle AgedHemorrhagic StrokeIntensive Care UnitsObservational Studies as TopicAnesthesiaBreathingFemalemedicine.symptomVentilator WeaningCohort studyAdultTRAUMATIC BRAIN-INJURYPressure support ventilationmechanical ventilationprognosis factorsACUTE LUNG INJURY03 medical and health sciencesmedicineHumansAgedIschemic StrokeMechanical ventilationNoninvasive Ventilationbusiness.industryMORTALITYneurologic patientsOrgan dysfunction030208 emergency & critical care medicineLength of Staymedicine.diseaseTRENDSRespiration Artificial030228 respiratory systemEtiologyNEUROCRITICAL CARENervous System DiseasesTracheotomybusinessCritical Care Medicine
researchProduct

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

2021

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 da…

Malepulmonary embolismInternationalitySettore MED/18 - CHIRURGIA GENERALEDeep veinVascular damage Radboud Institute for Health Sciences [Radboudumc 16]infectious diseasesCardiovascularSARS‐CoV‐2surgeryCOVID-19 ; SARS-CoV-2 ; deep vein thrombosis ; pulmonary embolism ; venous thromboembolismCohort StudiesPostoperative ComplicationsAnesthesiologyMedicine and Health SciencesProspective Studies610 Medicine & healthProspective cohort studyLung11 Medical and Health SciencesConfoundingHematologyMiddle AgedThrombosis17 Psychology and Cognitive SciencesCOVID-19; deep vein thrombosis; pulmonary embolism; SARS-CoV-2; venous thromboembolismPulmonary embolismCOVID-19; SARS-CoV-2; deep vein thrombosis; pulmonary embolism; venous thromboembolism.medicine.anatomical_structureCohortCOVID-19/complicationsPostoperative Complications/etiologyOriginal ArticleFemalePatient SafetyLife Sciences & BiomedicineCOVID-19; SARS-CoV-2; deep vein thrombosis; pulmonary embolism; venous thromboembolismHumanAdultmedicine.medical_specialtyAdolescentClinical Sciencesvenous thromboembolism610 Medicine & healthGlobalSurg CollaborativeVenous Thromboembolism/etiologydeep vein thrombosisNOCOVIDSurg CollaborativeYoung AdultMedicine General & InternalAge DistributionClinical ResearchCOVID‐19General & Internal MedicinemedicineHumansSex DistributionAgedScience & Technologybusiness.industrySARS-CoV-2PreventionNeurosciencesdeep vein thrombosiCOVID-19PneumoniaOdds ratioOriginal Articlesmedicine.diseaseSurgeryReconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10]Prospective StudieGood Health and Well BeingAnesthesiology and Pain MedicineHuman medicinePostoperative ComplicationCohort StudiebusinessVenous thromboembolism[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
researchProduct

Improve hip fracture outcome in the elderly patient (iHOPE) : A study protocol for a pragmatic, multicentre randomised controlled trial to test the e…

2018

IntroductionHip fracture surgery is associated with high in-hospital and 30-day mortality rates and serious adverse patient outcomes. Evidence from randomised controlled trials regarding effectiveness of spinal versus general anaesthesia on patient-centred outcomes after hip fracture surgery is sparse.Methods and analysisThe iHOPE study is a pragmatic national, multicentre, randomised controlled, open-label clinical trial with a two-arm parallel group design. In total, 1032 patients with hip fracture (>65 years) will be randomised in an intended 1:1 allocation ratio to receive spinal anaesthesia (n=516) or general anaesthesia (n=516). Outcome assessment will occur in a blinded manner aft…

Male1682medicine.medical_specialtyArthroplasty Replacement HipMedizinAnesthesia GeneralAnesthesia Spinallaw.inventionAnaesthesia03 medical and health sciencesClinical Trial Protocols as TopicPostoperative Complications0302 clinical medicineRandomized controlled trial030202 anesthesiologylawPragmatic Clinical Trials as TopicProtocolClinical endpointHumansMulticenter Studies as TopicMedicineGeneral anaesthesia1506ddc:610030212 general & internal medicineAgedRandomized Controlled Trials as TopicPain PostoperativeHip fracturegeriatric medicineHip Fracturesbusiness.industryMedical recordanaesthesia in orthopaedicsGeneral MedicinePerioperativeMiddle Agedmedicine.diseaseanaestheticsClinical trialTelephone interviewResearch DesignPhysical therapyFemalebusiness
researchProduct

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol…

2017

Background Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multice…

MaleLung DiseasesTime Factors[SDV]Life Sciences [q-bio]Respiratory Medicine and Allergymedicine.medical_treatmentRESPIRATORY-DISTRESS-SYNDROMEMedicine (miscellaneous)HemodynamicsMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Medicine (miscellaneous); Pharmacology (medical)LAPAROSCOPIC BARIATRIC SURGERYLung DiseaseBody Mass Indexlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationClinical ProtocolsRandomized controlled trialRisk Factors030202 anesthesiologylawMedicine and Health SciencesClinical endpointAnesthesiaPharmacology (medical)Respiratory function030212 general & internal medicineLungLungmedicin och allergi2. Zero hungerlcsh:R5-920ddc:617Positive end-expiratory pressurerespiratory systemOperative3. Good healthTreatment OutcomeRecruitment maneuverTIDAL VOLUMESResearch DesignMechanical ventilation Positive end-expiratory pressure Recruitment maneuver Obesity Postoperative pulmonary complicationSurgical Procedures OperativeAnesthesiaBreathingFemaleErratumlcsh:Medicine (General)ALVEOLAR RECRUITMENT MANEUVERHumancirculatory and respiratory physiologymedicine.medical_specialtyTime FactorMechanical ventilation ; Obesity ; Positive end-expiratory pressure ; Postoperative pulmonary complication ; Recruitment maneuverAnesthesia GeneralLung injuryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Body Mass Index; Clinical Protocols; Female; Humans; Intraoperative Care; Lung; Lung Diseases; Male; Obesity; Positive-Pressure Respiration; Protective Factors; Research Design; Risk Factors; Time Factors; Treatment Outcome; Anesthesia General; Surgical Procedures Operative; Medicine (miscellaneous); Pharmacology (medical)NOGENERAL-ANESTHESIADRIVING PRESSURE03 medical and health sciencesmedicineHumansddc:610ObesityClinical ProtocolGeneralProtective FactorPositive end-expiratory pressurePOSTOPERATIVE PULMONARY COMPLICATIONSMechanical ventilationSurgical ProceduresIntraoperative CareINTERNATIONAL CONSENSUSbusiness.industryRisk FactorProtective FactorsSurgeryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuverrespiratory tract diseasesbusinessPostoperative pulmonary complicationLUNG INJURY
researchProduct

RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study: Myocardial Dysfunction, Postoperative Neurocognitive Dysfunction, and 1 Year Foll…

2018

Background Remote ischemic preconditioning ( RIPC ) has been suggested to protect against certain forms of organ injury after cardiac surgery. Previously, we reported the main results of RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study, a multicenter trial randomizing 1403 cardiac surgery patients receiving either RIPC or sham‐ RIPC . Methods and Results In this follow‐up paper, we present 1‐year follow‐up of the composite primary end point and its individual components (all‐cause mortality, myocardial infarction, stroke and acute renal failure), in a sub‐group of patients, intraoperative myocardial dysfunction assessed by transesophageal echocardiography and the incidenc…

medicine.medical_specialtyTime FactorsMyocardial InfarctionNeurocognitive DisordersMyocardial Reperfusion InjuryNeuropsychological Tests030204 cardiovascular system & hematologyischemia/reperfusion injuryRisk Assessment03 medical and health sciencesCognition0302 clinical medicineDouble-Blind MethodRisk FactorsIschemiaGermanyMulticenter trialClinical StudiesClinical endpointHumansMedicineProspective Studies030212 general & internal medicineMyocardial infarctionCardiac Surgical ProceduresProspective cohort studyPropofolStrokeOriginal ResearchCardiovascular Surgerycardio‐vascular surgerybusiness.industryIncidenceProtective Factorsmedicine.diseaseSurgeryCardiac surgeryTreatment OutcomeIschemic Preconditioning MyocardialIschemic preconditioningremote ischemic preconditioningCardiology and Cardiovascular MedicinebusinessPropofolAnesthetics IntravenousEchocardiography Transesophagealmedicine.drug
researchProduct