Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study
Year: 2020
Type: article
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), 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 T ) 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 2 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 T and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.
Source: BMC Anesthesiology
Authors: FERS for the LAS VEGAS investigators, Chiara Robba, Sabrine N. T. Hemmes, Ary Serpa Neto, Thomas Bluth, Jaume Canet, Michael Hiesmayr, M. Wiersma Hollmann, Gary H. Mills, Marcos F. Vidal Melo, Christian Putensen, Samir Jaber, Werner Schmid, Paolo Severgnini, Hermann Wrigge, Denise Battaglini, Lorenzo Ball, Marcelo Gama de Abreu, Marcus J. Schultz, Paolo Pelosi
Institutions: Ospedale Policlinico San Martino, Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, Hospital Israelita Albert Einstein, University Hospital Carl Gustav Carus, Technische Universität Dresden, Hospital Universitari Germans Trias i Pujol, Medical University of Vienna, Sheffield Teaching Hospitals NHS Foundation Trust, University of Sheffield, Massachusetts General Hospital, University Hospital Bonn, Université de Montpellier, Hôpital Saint Eloi, University of Insubria, Ospedale di Circolo e Fondazione Macchi, University Hospital Leipzig, Leipzig University, University of Genoa, Mahidol University, Mahidol Oxford Tropical Medicine Research Unit
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,084
Funders: Amsterdam University Medical Centers, National Institute for Health and Care Research, Mahidol University, Università degli Studi di Genova, Università degli Studi dell'Insubria, Sociedade Beneficente Israelita Brasileira Albert Einstein, Université de Montpellier, Miljø- og Fødevareministeriet, European Society of Anaesthesiology, National Institutes of Health, National Heart, Lung, and Blood Institute
OpenAlex ID: W3014158677