6533b831fe1ef96bd1298f30

RESEARCH PRODUCT

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

Sunny G NijbroekLiselotte HolPien SwartSabrine N T HemmesAry Serpa NetoJan M BinnekadeGoran HedenstiernaSamir JaberMichael HiesmayrMarkus W HollmannGary H MillsMarcos F Vidal MeloChristian PutensenWerner SchmidPaolo SevergniniHermann WriggeMarcelo Gama De AbreuPaolo PelosiSchultzMarcus JWolfgang KroellHelfried MetzlerGerd StruberThomas WegscheiderHans GombotzMichael HiesmayrWerner SchmidBernhard UrbanekDavid KahnMona MomeniAudrey PospiechFernande LoisPatrice ForgetIrina GrosuJan PoelaertVeerle Van MosseveldeMarie-claire Van MalderenDimitri DylstJeroen Van MelkebeekMaud BeranStefan De HertLuc De BaerdemaekerBjorn HeyseJurgen Van LimmenPiet WyffelsTom JacobsNathalie RoelsAnn De BruyneStijn Van De VeldeBrigitte LevaSandrine DamsterBenoit PlichonMarina Juros-zovkoDejana Djonoviċ- OmanoviċSelma PernarJosip ZunicPetar MiskovicAntonio ZilicSlavica KvolikDubravka IvicDarija Azenic-venzeraSonja SkiljicHrvoje VinkovicIvana OputricKazimir JuricicVedran FrkovicJasminka KopicIvan MirkovicNenad KaranovicMladen CarevNatasa DropulicJadranka Pavicic SaricGorjana ErcegMatea Bogdanovic DvorscakBranka Mazul-sunkoAnna Marija PavicicTanja GoranovicBranka MaldiniTomislav RadocajZeljka GavranovicInga Mladic-batinicaMirna SehovicPetr StouracHana HarazimOlga SmekalovaMartina KosinovaTomas KolacekKamil HudacekMichal DrabJan BrujevicKaterina VitkovaKaterina JirmanovaIvana VolfovaPaula DzurnakovaKatarina LiskovaRadovan DudasRadek FilipskySamir El KafrawHisham Hosny AbdelwahabTarek MetwallyAhmed Abdel-razekAhmed Mostafa El-shaarawyHany YassinMohamed MagdyMahdy AbdelhadyMohamed MahranEiko HerodesPeeter KivikJuri OganjanAnnika AunAlar SormusKaili SarapuuMerilin MallJuri KarjaginEmmanuel FutierAntoine PetitAdeline GerardEmmanuel MarretMarc SolierSamir JaberAlbert PradesJens KrasslerSimone MerzkyMarcel Gama De AbreuChristopher UhligThomas KissAnette BundyThomas BluthAndreas GueldnerPeter SpiethMartin ScharffenbergDenny Tran ThiemThea KochTanja TreschanMaximilian SchaeferBea BastinJohann GeibMartin WeissPeter KienbaumBenedikt PannenAndre GottschalkMirja KonradDiana WesterheideBen SchwerdtfegerHermann WriggePhilipp SimonAndreas ReskeChristian NestlerDimitrios ValsamidisKonstantinos StroumpoulisGeorgios AntholopoulosAntonis AndreouDimitris KarapanosKassiani TheodorakiGeorgios GkiokasMarios-konstantinos TasoulisTatiana SidiropoulouFoteini ZafeiropoulouPanagiota FlorouAggeliki PandaziGeorgia TsaousiChristos NourisChryssa PourzitakiDmitri BystritskiReuven PizovArieh EdenCaterina Valeria PesceAnnamaria CampanileAntonella MarrellaSalvatore GrassoMichele De MicheleFrancesco BonaGianmarco GiacolettoElena SardoLuigi GiancarloVicari SottosantiMaurizio SolcaCarlo Alberto VoltaSavino SpadaroMarco VerriRiccardo RagazziRoberto ZoppellariGilda CinnellaPasquale RaimondoDaniela La BellaLucia MirabellaDavide D'antiniPaolo PelosiAlexandre MolinIole BrunettiAngelo GratarolaGiulia PelleranoRosanna SileoStefano PezzattoLuca MontagnaniLaura PasinGiovanni LandoniAlberto ZangrilloLuigi BerettaAmbra Licia Di ParmaValentina TarziaRoberto DossiMarta Eugenia SassoneDaniele SancesStefano TrediciGianluca SpanoGianluca CastellaniLuigi DelunasSopio PeradzeMarco VenturinoInes ArpinoSara SherConcezione TommasinoFrancesca RapidoPaola MorelliMaria VargasGiuseppe ServilloAndrea CortegianiSanti Maurizio RaineriFrancesca MontaltoVincenzo RussottoAntonino GiarratanoMarco BaciarelloMichela GeneraliGiorgia CeratiYigal LeykinFilippo BressanVittoria BartoliniLucia ZamideiLuca BrazziCorrado LiperiGabriele SalesLaura PistiddaPaolo SevergniniElisa BrugnoniGiuseppe MusellaAlessandro BacuzziDalip MuhardriGecaj-gashi AgretaFatos SadaAdem BytyqiAurika KarbonskieneRuta AukstakalnieneZivile TeberaiteErika SalciuteRenatas TikuisisPovilas MiliauskasSipylaite JurateEgle KontrimaviciuteGabija TomkuteJohn XuerebMaureen BezzinaFrancis Joseph BorgSabrine HemmesMarcus SchultzMarkus HollmannIrene WiersmaChrista BoerAnne DuvekotBas In  ‘T VeldAlice WergerPaul DennesenCharlotte SeverijnsJasper De JongJens HeringRienk Van BeekStefan IvarsIb JammerAlena BreidablikKatharina Skirstad HodtFrode FjellangerManuel Vico AvalosJannicke Mellin-olsenElisabeth AnderssonAmir Shafi-kabirRuby MolinaStanley WutaiErick MoraisGlória TarecoDaniel FerreiraJoana AmaralMaria De LurdesGoncalves CastroSusana CadilhaSofia AppletonSuzana ParenteMariana CorreiaDiogo MartinsAngela MonteirosaAna RicardoSara RodriguesLucian HorhotaIoana Marina GrintescuLiliana MireaIoana Cristina GrintescuDan CorneciSilvius NegoitaMadalina DutuIoana Popescu GarotescuDaniela FilipescuAlexandru Bogdan ProdanGabriela DrocRuxandra FotaMihai PopescuDana TomescuAna Maria PetcuMarian Irinel TudoroiuAlida MoiseCatalin-traian GuranIorel GherghinaDan CosteaIulia CindeaSanda-maria CopotoiuRuxandra CopotoiuVictoria BarsanZsolt TolcserMagda RiciuSeptimiu Gheorghe MoldovanMihaly VeresAlexey GritsanTatyana KapkanGalina GritsanOleg KorolkovAlexander KulikovAndrey LubninAlexey OvezovPavel ProkoshevAlexander LugovoyNatalia AnipchenkoAndrey BabayantsIrina KomissarovaKarginova ZalinaValery LikhvantsevSergei FedorovAleksandra LazukicJasmina PejakovicDunja MihajlovicZuzana KusnierikovaMaria ZelinkovaKatarina BruncakovaLenka PolakovicovaVilliam SobonaBarbka Novak-supeAna Pekle-golezMiroljub JovanovBranka StrazisarJasmina Markovic-boziVesna Novak-jankovicMinca VojeAndriy GrynyukIvan KostadinovAlenka Spindler-veselVictoria MoralMari Carmen UnzuetaCarlos PuigboJosep FavaJaume CanetEnrique MoretMónica Rodriguez NunezMar SendraAndrea BrunelliFrederic RodenasPablo MonederoFrancisco Hidalgo MartinezMaria Jose Yepes TeminoAntonio Martínez SimonAna De Abajo LarribaAlberto LisiGisela PerezRaquel MartinezManuel GranellJose Tatay VivoCristina Saiz RuizJose Antonio De Andrés IbañezErnesto PastorMarina SoroCarlos FerrandoMario DefezCesar Aldecoa Alvares-santullanoRocio PerezJesus RicoMonir JawadYousif SaeedLars GillbergZuleyha Kazak BengisunBaturay Kansu KazbekNesil CoskunfiratNeval BoztugSuat SanliMurat YilmazNecmiye HadimiogluNuzhet Mert SenturkEmre CamciSemra KucukgoncuZerrin SungurNukhet SivrikozSerpil Ustalar OzgenFevzi ToramanOnur SelviOzgur SenturkMine YildizBahar KuvakiFerim GunencSemih KucukgucluŞUle OzbilginJale MaralSeyda CanliOguzhan ArunAli SaltaliEyup AydoganFatma Nur AkgunCeren SanlikaripFatma Mine KaramanAndriy MazurSergiy VorotyntsevGuy RousseauColin BarrettLucia StancombeBen ShelleyHelen ScholesJames LimbAmir RafiLisa WaymanJill DeaneDavid RogersonJohn WilliamsSusan YatesElaine RogersMark PulletzSarah MoretonStephanie JonesSuresh VenkateshMaudrian BurtonLucy BrownCait GoodallMatthew RucklidgeDebbie FullerMaria NadolskiSandeep KusreMichael LundbergLynn EverettMaka ZuleikaPeter CarvalhoDeborah ClementsBen Creagh-brownPhilip WattParizade RaymodeRupert PearseOtto MohrAshok RajThais CrearyAhmed ChishtiAndrea BellCharley HighamAlistair CainSarah GibbStephen MowatDanielle FranklinClaire WestGary MintoNicholas BoydGary MillsEmily CaltonRachel WalkerFelicity MackenzieBranwen EllisonHelen RobertsMoses ChikungwaClare JacksonAndrew DonovanJayne FootElizabeth HomanJane MontgomeryDavid PortchPauline MercerJanet PalmerJonathan PaddleAnna FouracresAmanda DatsonAlyson AndrewLeanne WelchAlastair RoseSandeep VarmaKaren SimesonMrutyunjaya RambhatlaJaysimha SusarlaSudhakar MarriKrishnan KodaganallurAshok DasShivarajan AlgarsamyJulie ColleySimon DaviesMargaret SzewczykThomas SmithAna Fernandez- BustamanteElizabeth LuzierAngela AlmagroMarcos Vidal MeloLuiz FernandoDemet SulemanjiJuraj SprungToby WeingartenDaryl KorFederica ScavonettoYeo Tze

subject

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

description

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 of LTVV, defined as V(T) of 8 ml kg(−1) or less predicted bodyweight (PBW). A V(T) was deemed ‘default’ if the set V(T) was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default V(T) was often set, both in women and men; mode V(T) was 500 ml. Median [IQR] V(T) was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg(−1) PBW, P*** < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P*** < 0.001]. In the mediation analysis, patients’ height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default V(T). CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher V(T) than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV. TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

yearjournalcountryeditionlanguage
2021-10-01
10.1097/eja.0000000000001476http://hdl.handle.net/10447/492777