0000000000461269

AUTHOR

Christian Putensen

showing 11 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
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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
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Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries

2021

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs…

Malemedicine.medical_specialtyCritical Illnessmedicine.medical_treatmentAged; Critical Illness; Female; Heart Arrest; Humans; Hypotension; Hypoxia; Intensive Care Units; Intubation Intratracheal; Logistic Models; Male; Medical Errors; Middle Aged; Prospective Studies; Respiration Artificial; Respiratory Insufficiency; Vasoconstrictor Agents01 natural sciencesNOtracheal intubation ; adverse peri-intubation events03 medical and health sciences0302 clinical medicineInterquartile rangeIntensive careSettore MED/41 - ANESTESIOLOGIAIntubation IntratrachealHumansVasoconstrictor AgentsMedicineIntubationIntubation Critical CareProspective Studies030212 general & internal medicine0101 mathematics610 Medicine & healthHypoxiaProspective cohort studyAgedMedical Errorsbusiness.industryRespiration010102 general mathematicsTracheal intubationGeneral MedicineMiddle AgedRespiration ArtificialHeart ArrestIntratrachealIntensive Care UnitsIntubation procedureLogistic ModelsRespiratory failureArtificialEmergency medicineFemaleAirway managementHypotensionIntubationRespiratory Insufficiencybusiness
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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
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Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensiv…

2016

Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were rece…

MalePediatricsARDSmedicine.medical_treatmentlaw.inventionPositive-Pressure Respiration0302 clinical medicinelawRisk FactorsPrevalenceventilator–induced lung injuryProspective StudiesHospital MortalityProspective cohort studyTidal volumeeducation.field_of_studyRespiratory Distress SyndromeAcute respiratory distress syndrometidal volumeARDS critically ill ventilationMiddle AgedIntensive care unitIntensive Care UnitsCritical IllneFemaleHumanPulmonary and Respiratory Medicinemedicine.medical_specialtyCritical IllnessPopulationIntensive Care UnitLung injurymechanical ventilationNO03 medical and health sciencesIntensive caremedicineAcute respiratory distress syndrome mechanical ventilation ventilator–induced lung injury tidal volume positive end–expiratory pressureHumansMED/41 - ANESTESIOLOGIAeducationAgedMechanical ventilationbusiness.industryRisk FactorRespiratory Distress Syndrome Adult030208 emergency & critical care medicinemedicine.diseaseRespiration ArtificialMechanical ventilation Acute respiratory failure Acute respiratory distress syndromeProspective Studie030228 respiratory systemEmergency medicinepositive end–expiratory pressurebusiness
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Additional file 1 of The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal su…

2021

Additional file 1: Table 1. Patient and surgery related characteristics. Table 2. Intraoperative venitlatory setting by group.

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Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications:LAS VEGAS - An observationa…

2017

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative venti…

MalePediatricsInternationalityRESPIRATORY-DISTRESS-SYNDROME0302 clinical medicinePostoperative Complications030202 anesthesiologyRisk FactorsEpidemiologyABDOMINAL-SURGERY80 and overMedicine and Health SciencesGeneral anaesthesiaAnesthesiaEND-EXPIRATORY-PRESSUREBERLIN DEFINITION030212 general & internal medicineProspective StudiesProspective cohort studyLungAged 80 and overFramingham Risk ScoreIncidence (epidemiology)RespirationMiddle AgedTreatment OutcomeArtificialFemalePRACTICE PATTERNSHumanmedicine.medical_specialtymechanical ventilation ; prospective observational study ; Intensive careAnesthesia GeneralNONCARDIOTHORACIC SURGERYNOAged; Aged 80 and over; Anesthesia General; Cross-Sectional Studies; Female; Humans; Intraoperative Care; Lung; Male; Middle Aged; Postoperative Complications; Prospective Studies; Respiration Disorders; Respiration Artificial; Risk Factors; Tidal Volume; Treatment Outcome; Internationality; Anesthesiology and Pain MedicineACUTE LUNG INJURY03 medical and health sciencesGENERAL-ANESTHESIAInternal medicinemedicineJournal ArticleTidal VolumeHumansMED/41 - ANESTESIOLOGIAGeneralAgedCross-Sectional StudieIntraoperative Carebusiness.industryRisk FactorRespiration DisorderRespiration DisordersRespiration ArtificialConfidence intervalPROTECTIVE MECHANICAL VENTILATIONProspective StudieAnesthesiology and Pain MedicineCross-Sectional StudiesRelative riskMAJOR NONCARDIAC SURGERYPostoperative ComplicationbusinessAbdominal surgery
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Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

2021

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (V(T)). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES: Women and men were compared with respect to use o…

AdultMalemedicine.medical_specialtyIntra operativehealth care facilities manpower and services[SDV]Life Sciences [q-bio]Critical IllnessLas Vegas StudyArticle03 medical and health sciences0302 clinical medicine030202 anesthesiologyInternal medicineTidal VolumemedicineHumansGeneral anaesthesiaLungTidal volumeAdult; Critical Illness; Female; Humans; Lung; Male; Tidal Volume; Respiration Artificial; Sex CharacteristicsSex CharacteristicsLas vegasbusiness.industryRespirationrespiratory failure sexrespiratory systemSex differenceRespiration Artificialrespiratory tract diseasesAnesthesiology and Pain Medicine030228 respiratory systemRelative riskArtificialCohortBreathingFemaleObservational studybusinessintra-operative tidal volumecirculatory and respiratory physiology
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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
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Additional file 2 of The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal su…

2021

Additional file 2: Table S1. Definition of postoperative pulmonary complications. Table S2. Definition of intraoperative complications. Table S3. Number of data available at each time point. Table S4. Patients demographics and surgery–related characteristics in the matched cohort for type of surgery. Table S5. Intraoperative and postoperative outcomes in matched cohort for type of surgery. Table S6. Mixed multivariable logistic regression in matched cohort for postoperative pulmonary complications. Figure S1. Time weighted average and coefficient of variation calculation. Figure S2. Summary plot of covariate balance for time-weighted ΔP before (red line) and after (blue line) conditioning f…

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Additional file 1 of Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: p…

2020

Additional file 1.

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