Correction to: Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protocol for a randomized controlled trial.
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…
General Aspects of Thoracic Anesthesia
Thoracic anesthesia, a fascinating subspecialty, provides perioperative medicine for a spectrum of dynamically evolving surgical procedures ranging from classical thoracotomies to minimally invasive and ultra-minimally invasive video or robotically assisted procedures. Its core mission is to provide optimal surgical conditions by deflating the operative lung while providing adequate oxygenation and avoiding injury to the ventilated lung. Thoracic anesthesia also provides preoperative care to achieve best possible health status before surgery and improves postoperative recovery by providing means of pain therapy and enhanced recovery following some of the most painful procedures in patients …
Distribution of ventilation and oxygenation in surgical obese patients ventilated with high versus low positive end-expiratory pressure: A substudy of a randomised controlled trial
BACKGROUND Intra-operative ventilation using low/physiological tidal volume and positive end-expiratory pressure (PEEP) with periodic alveolar recruitment manoeuvres (ARMs) is recommended in obese surgery patients.OBJECTIVES To investigate the effects of PEEP levels and ARMs on ventilation distribution, oxygenation, haemodynamic parameters and cerebral oximetry.DESIGN A substudy of a randomised controlled trial.SETTING Tertiary medical centre in Geneva, Switzerland, between 2015 and 2018.PATIENTS One hundred and sixty-two patients with a BMI at least 35 kg per square metre undergoing elective open or laparoscopic surgery lasting at least 120 min.INTERVENTION Patients were randomised to PEEP…