Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients : Post-hoc analysis of LAS VEGAS study
(2020) In BMC Anesthesiology 20(1).- Abstract
Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine),... (More)
Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.
(Less)
- author
- contributor
- Kroell, Wolfgang
; Metzler, Helfried
; Struber, Gerd
; Wegscheider, Thomas
; Gombotz, Hans
; Hiesmayr, Michael
; Schmid, Werner
; Urbanek, Bernhard
; Kahn, David
; Momeni, Mona
; Pospiech, Audrey
; Lois, Fernande
; Forget, Patrice
; Grosu, Irina
; Poelaert, Jan
; Van Mossevelde, Veerle
; Van Malderen, Marie Claire
; Dylst, Dimitri
; Van Melkebeek, Jeroen
; Beran, Maud
; De Hert, Stefan
; De Baerdemaeker, Luc
; Heyse, Bjorn
; Van Limmen, Jurgen
; Wyffels, Piet
; Jacobs, Tom
; Roels, Nathalie
; De Bruyne, Ann
; Petit, Antoine
; Martinez, Francisco Hidalgo
and Jawad, Monir
LU
- author collaboration
- publishing date
- 2020-04-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- LAS VEGAS, Mechanical ventilation, Neurosurgery, Postoperative pulmonary complications
- in
- BMC Anesthesiology
- volume
- 20
- issue
- 1
- article number
- 73
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85082895096
- pmid:32241266
- ISSN
- 1471-2253
- DOI
- 10.1186/s12871-020-00988-x
- language
- English
- LU publication?
- no
- additional info
- Funding Information: LAS VEGAS was partly sponsored by the European Society of Anaesthesiology and the Amsterdam University Medical Centers, location ‘AMC’. It was also funded by a grant from the AAGBI via the NIAA in the UK. MFVM was supported by grant NIH-NHLBI UG3-HL140177. Funders provided support for logistic and study development. Funding Information: LAS VEGAS [8] was an international multicentre observational prospective study (registered at www. clini-caltrials.gov (study identifier NCT01601223)), endorsed and supported by the European Society of Anaesthesiology and the Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands. Details about the LAS VEGAS study collaborators, participating centres and hospital characteristics of participating centres are reported in ESM Tables S2a, b and S3. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
- id
- 16117a3b-8ca9-4604-80f1-495d5c186b52
- date added to LUP
- 2021-02-25 15:01:35
- date last changed
- 2024-06-13 07:24:38
@article{16117a3b-8ca9-4604-80f1-495d5c186b52,
abstract = {{<p>Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (V<sub>T</sub>) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH<sub>2</sub>0. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low V<sub>T</sub> and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.</p>}},
author = {{Robba, Chiara and Hemmes, Sabrine N.T. and Serpa Neto, Ary and Bluth, Thomas and Canet, Jaume and Hiesmayr, Michael and Hollmann, M. Wiersma and Mills, Gary H. and Vidal Melo, Marcos F. and Putensen, Christian and Jaber, Samir and Schmid, Werner and Severgnini, Paolo and Wrigge, Hermann and Battaglini, Denise and Ball, Lorenzo and Gama De Abreu, Marcelo and Schultz, Marcus J. and Pelosi, Paolo}},
issn = {{1471-2253}},
keywords = {{LAS VEGAS; Mechanical ventilation; Neurosurgery; Postoperative pulmonary complications}},
language = {{eng}},
month = {{04}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{BMC Anesthesiology}},
title = {{Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients : Post-hoc analysis of LAS VEGAS study}},
url = {{http://dx.doi.org/10.1186/s12871-020-00988-x}},
doi = {{10.1186/s12871-020-00988-x}},
volume = {{20}},
year = {{2020}},
}