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

6533b82dfe1ef96bd12909c4

RESEARCH PRODUCT

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications:LAS VEGAS - An observational study in 29 countries

Marcus J. Schultz Sabrine N. T. Hemmes Ary Serpa Neto Jan M. Binnekade Jaume Canet Goran Hedenstierna Samir Jaber Michael Hiesmayr Markus W. Hollmann Gary H. Mills Marcos F. Vidal Melo Rupert Pearse Christian Putensen Werner Schmid Paolo Severgnini Hermann Wrigge Marcelo Gama De Abreu Paolo Pelosi Kroell W Metzler H Struber G Wegscheider T Gombotz H Hiesmayr M Schmid W Urbanek B Leva B Damster S Plichon B Kahn D Momeni M Pospiech A Lois F Forget P Grosu I Poelaert J Van Mossevelde V Van Malderen Mc Dylst D Van Melkebeek J Beran M De Hert S De Baerdemaeker L Heyse B Van Limmen J Wyffels P Jacobs T Roels N De Bruyne A Van De Velde S Juros-zovko M Djonoviċ-omanoviċ D Serpa Neto A Pernar S Zunic J Miskovic P Zilic A Kvolik S Ivic D Azenic-venzera D Skiljic S Vinkovic H Oputric I Juricic K Frkovic V Kopic J Mirkovic I Karanovic N Carev M Dropulic N Pavičić-šarić J Erceg G Bogdanović Dvorščak M Mazul-sunko B Pavicic Am Goranovic T Maldini B Radocaj T Gavranovic Z Mladic-batinica I Sehovic M Stourac P Harazim H Smekalova O Kosinova M Kolacek T Hudacek K Drab M Brujevic J Vitkova K Jirmanova K Volfova I Dzurnakova P Liskova K Dudas R Filipsky R El Kafrawy S Hosny Abdelwahab H Metwally T Abdel-razek A El-shaarawy Am Fathy Hasan W Gouda Ahmed A Yassin H Magdy M Abdelhady M Mahran M Herodes E Kivik P Oganjan J Aun A Sormus A Sarapuu K Mall M Karjagin J Futier E Petit A Gerard A Marret E Solier M Jaber S Prades A Putensen C Krassler J Merzky S Gama De Abreu M Uhlig C Kiss T Bundy A Bluth T Güldner A Spieth P Scharffenberg M Tran Thiem D Koch T Treschan T Schaefer M Bastin B Geib J Weiss M Kienbaum P Pannen B Gottschalk A Konrad M Westerheide D Schwerdtfeger B Wrigge H Simon P Reske A Nestler C Valsamidis D Stroumpoulis K Antholopoulos G Andreou A Karapanos D Theodoraki K Gkiokas G Tasoulis Mk Sidiropoulou T Zafeiropoulou F Florou P Pandazi A Tsaousi G Nouris C Pourzitaki C Bystritski D Pizov R Eden A Pesce Cv Campanile A Marrella A Grasso S De Michele M Bona F Giacoletto G Sardo E Giancarlo L Sottosanti V Solca M Volta Ca Spadaro S Verri M Ragazzi R Zoppellari R Cinnella G Raimondo P La Bella D Mirabella L D'antini D Pelosi P Molin A Brunetti I Gratarola A Pellerano G Sileo R Pezzatto S Montagnani L Pasin L Landoni G Zangrillo A Beretta L Di Parma Al Tarzia V Dossi R Sassone Me Sances D Tredici S Spano G Castellani G Delunas L Peradze S Venturino M Arpino I Sher S Tommasino C Rapido F Morelli P Vargas M Servillo G Cortegiani A Raineri Sm Montalto F Russotto V Giarratano A Baciarello M Generali M Cerati G Leykin Y Bressan F Bartolini V Zamidei L Brazzi L Liperi C Sales G Pistidda L Severgnini P Brugnoni E Musella G Bacuzzi A Muhardri D Gecaj-gashi A Sada F Bytyqi A Karbonskiene A Aukstakalniene R Teberaite Z Salciute E Tikuisis R Miliauskas P Jurate S Kontrimaviciute E Tomkute G Xuereb J Bezzina M Borg Fj Hemmes S Schultz M Hollmann M Wiersma I Binnekade J Bos L Boer C Duvekot A In 'T Veld B Werger A Dennesen P Severijns C De Jong J Hering J Van Beek R Ivars S Jammer I Breidablik A Skirstad Hodt K Fjellanger F Vicoavalos M Mellin-olsen J Andersson E Shafi-kabiri A Molina R Wutai S Morais E Tareco Gr Ferreira D Amaral J Gonçalves Castro Ml Cadilha S Appleton S Parente S Correia M Martins D Monteirosa A Ricardo A Rodrigues S Horhota L Grintescu Im Mirea L Grintescu Ic Corneci D Negoita S Dutu M Popescu Garotescu I Filipescu D Prodan Ab Droc G Fota R Popescu M Tomescu D Petcu Am Tudoroiu Mi Moise A Guran Ct Gherghina I Costea D Cindea I Copotoiu Sm Copotoiu R Barsan V Tolcser Z Riciu M Moldovan Gs Veres M Gritsan A Kapkan T Gritsan G Korolkov O Kulikov A Lubnin A Ovezov A Prokoshev P Lugovoy A Anipchenko N Babayants A Komissarova I Zalina K Likhvantsev V Fedorov S Lazukic A Pejakovic J Mihajlovic D Kusnierikova Z Zelinkova M Bruncakova K Polakovicova L Sobona V Novak-supe B Pekle-golez A Jovanov M Strazisar B Markovic-bozic J Novak-jankovic V Voje M Grynyuk A Kostadinov I Spindler-vesel A Moral V Unzueta C Puigbo C Fava J Canet J Moret E Rodriguez Nunez Mn Sendra M Brunelli A Rodenas F Monedero P Hidalgo Martinez F Yepes Temino Mj Marti Nez Simon A De Abajo Larriba A Lisi A Perez G Martinez R Granell M Tatay Vivo J Saiz Ruiz C De Andre S Iban Ez Ja Pastor E Soro M Ferrando C Defez M Aldecoa Alvares-santullano C Pere R Rico J Jawad M Saeed Y Gillberg L Hedenstierna G Kazak Bengisun Z Kansu Kazbek B Coskunfirat N Boztug N Sanli S Yilmaz M Hadimioglu N Senturk Nm Camci E Kucukgoncu S Sungur Z Sivrikoz N Ustalar Ozgen S Toraman F Selvi O Senturk O Yildiz M Kuvaki B Gunenc F Kucukguclu S Ozbilgin Su Maral J Canli S Arun O Saltali A Aydogan E Akgün Fn Sanlikarip C Mine Karaman F Mazur A Vorotyntsev S Rousseau G Barrett C Stancombe L Shelley B Scholes H Limb J Rafi A Wayman L Deane J Rogerson D Williams J Yates S Rogers E Pulletz M Moreton S Jones S Venkatesh S Burton M Brown L Goodall C Rucklidge M Fuller D Nadolski M Kusre S Lundberg M Everett L Nutt H Zuleika M Carvalho P Clements D Creagh-brown B Watt P Raymode P Pearse R Mohr O Raj A Creary T Chishti A Bell A Higham C Cain A Gibb S Mowat S Franklin D West C Minto G Boyd N Mills G Calton E Walker R Mackenzie F Ellison B Roberts H Chikungwa M Jackson C Donovan A Foot J Homan E Montgomery J Portch D Mercer P Palmer J Paddle J Fouracres A Datson A Andrew A Welch L Rose A Varma S Simeson K Rambhatla M Susarla J Marri S Kodaganallur K Das A Algarsamy S Colley J Davies S Szewczyk M Smith T Fernandez-bustamante A Luzier E Almagro A Vidal Melo M Fernando L Sulemanji D Sprung J Weingarten T Kor D Scavonetto F Tze Y.

subject

Male Pediatrics Internationality RESPIRATORY-DISTRESS-SYNDROME 0302 clinical medicine Postoperative Complications 030202 anesthesiology Risk Factors Epidemiology ABDOMINAL-SURGERY 80 and over Medicine and Health Sciences General anaesthesia Anesthesia END-EXPIRATORY-PRESSURE BERLIN DEFINITION 030212 general & internal medicine Prospective Studies Prospective cohort study Lung Aged 80 and over Framingham Risk Score Incidence (epidemiology)Respiration Middle Aged Treatment Outcome Artificial Female PRACTICE PATTERNS Human medicine.medical_specialty mechanical ventilation ; prospective observational study ; Intensive care Anesthesia General NONCARDIOTHORACIC SURGERY NO Aged; 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 Medicine ACUTE LUNG INJURY 03 medical and health sciences GENERAL-ANESTHESIA Internal medicine medicine Journal Article Tidal Volume Humans MED/41 - ANESTESIOLOGIA General Aged Cross-Sectional Studie Intraoperative Care business.industry Risk Factor Respiration Disorder Respiration Disorders Respiration Artificial Confidence interval PROTECTIVE MECHANICAL VENTILATION Prospective Studie Anesthesiology and Pain Medicine Cross-Sectional Studies Relative risk MAJOR NONCARDIAC SURGERY Postoperative Complication business Abdominal surgery

description

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 ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.

year	journal	country	edition	language
2017-08-01

10.1097/eja.0000000000000646 https://research.vumc.nl/en/publications/d96d0b78-6a07-44cc-a1fa-353f509dd54a