Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: Post-hoc analysis of LAS VEGAS study

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, Wolfgang KroellHelfried Metzler, Gerd Struber, Thomas Wegscheider, Hans Gombotz, Michael Hiesmayr, Werner Schmid, Bernhard Urbanek, David Kahn, Mona Momeni, Audrey Pospiech, Fernande Lois, Patrice Forget, Irina Grosu, Jan Poelaert, Veerle Van Mossevelde, Marie Claire Van Malderen, Dimitri Dylst, Jeroen Van Melkebeek, Maud Beran, Stefan De Hert, Luc De Baerdemaeker, Bjorn Heyse, Jurgen Van Limmen, Piet Wyffels, Tom Jacobs, Nathalie Roels, Ann De Bruyne, Stijn Van De Velde, Brigitte Leva, Sandrine Damster, Benoit Plichon, Marina Juros-Zovko, Dejana Djonoviċ-Omanoviċ, Selma Pernar, Josip Zunic, Petar Miskovic, Antonio Zilic, Slavica Kvolik, Dubravka Ivic, Darija Azenic-Venzera, Sonja Skiljic, Hrvoje Vinkovic, Ivana Oputric, Kazimir Juricic, Vedran Frkovic, Jasminka Kopic, Ivan Mirkovic, Nenad Karanovic, Mladen Carev, Natasa Dropulic, Jadranka Pavicic Saric, Gorjana Erceg, Matea Bogdanovic Dvorscak, Branka Mazul-Sunko, Anna Marija Pavicic, Tanja Goranovic, Branka Maldini, Tomislav Radocaj, Zeljka Gavranovic, Inga Mladic-Batinica, Mirna Sehovic, Petr Stourac, Hana Harazim, Olga Smekalova, Martina Kosinova, Tomas Kolacek, Kamil Hudacek, Michal Drab, Jan Brujevic, Katerina Vitkova, Katerina Jirmanova, Ivana Volfova, Paula Dzurnakova, Katarina Liskova, Radovan Dudas, Radek Filipsky, Samir El Kafrawy, Hisham Hosny Abdelwahab, Tarek Metwally, Ahmed Abdel-Razek, Ahmed Mostafa El-Shaarawy, Wael Fathy Hasan, Ahmed Gouda Ahmed, Hany Yassin, Mohamed Magdy, Mahdy Abdelhady, Mohamed Mahran, Eiko Herodes, Peeter Kivik, Juri Oganjan, Annika Aun, Alar Sormus, Kaili Sarapuu, Merilin Mall, Juri Karjagin, Emmanuel Futier, Antoine Petit, Adeline Gerard, Emmanuel Marret, Marc Solier, Samir Jaber, Albert Prades, Jens Krassler, Simone Merzky, Marcel Gama De Abreu, Christopher Uhlig, Thomas Kiss, Anette Bundy, Thomas Bluth, Andreas Gueldner, Peter Spieth, Martin Scharffenberg, Denny Tran Thiem, Thea Koch, Tanja Treschan, Maximilian Schaefer, Bea Bastin, Johann Geib, Martin Weiss, Peter Kienbaum, Benedikt Pannen, Andre Gottschalk, Mirja Konrad, Diana Westerheide, Ben Schwerdtfeger, Hermann Wrigge, Philipp Simon, Andreas Reske, Christian Nestler, Dimitrios Valsamidis, Konstantinos Stroumpoulis, Georgios Antholopoulos, Antonis Andreou, Dimitris Karapanos, Kassiani Theodoraki, Georgios Gkiokas, Marios Konstantinos Tasoulis, Tatiana Sidiropoulou, Foteini Zafeiropoulou, Panagiota Florou, Aggeliki Pandazi, Georgia Tsaousi, Christos Nouris, Chryssa Pourzitaki, Dmitri Bystritski, Reuven Pizov, Arieh Eden, Caterina Valeria Pesce, Annamaria Campanile, Antonella Marrella, Salvatore Grasso, Michele De Michele, Francesco Bona, Gianmarco Giacoletto, Elena Sardo, Luigi Giancarlo, Vicari Sottosanti, Maurizio Solca, Carlo Alberto Volta, Savino Spadaro, Marco Verri, Riccardo Ragazzi, Roberto Zoppellari, Gilda Cinnella, Pasquale Raimondo, Daniela La Bella, Lucia Mirabella, Davide D'Antini, Paolo Pelosi, Alexandre Molin, Iole Brunetti, Angelo Gratarola, Giulia Pellerano, Rosanna Sileo, Stefano Pezzatto, Luca Montagnani, Laura Pasin, Giovanni Landoni, Alberto Zangrillo, Luigi Beretta, Ambra Licia Di Parma, Valentina Tarzia, Roberto Dossi, Marta Eugenia Sassone, Daniele Sances, Stefano Tredici, Gianluca Spano, Gianluca Castellani, Luigi Delunas, Sopio Peradze, Marco Venturino, Ines Arpino, Sara Sher, Concezione Tommasino, Francesca Rapido, Paola Morelli, Maria Vargas, Giuseppe Servillo, Andrea Cortegiani, Santi Maurizio Raineri, Francesca Montalto, Vincenzo Russotto, Antonino Giarratano, Marco Baciarello, Michela Generali, Giorgia Cerati, Yigal Leykin, Filippo Bressan, Vittoria Bartolini, Lucia Zamidei, Luca Brazzi, Corrado Liperi, Gabriele Sales, Laura Pistidda, Paolo Severgnini, Elisa Brugnoni, Giuseppe Musella, Alessandro Bacuzzi, Dalip Muhardri, Agreta Gecaj-Gashi, Fatos Sada, Adem Bytyqi, Aurika Karbonskiene, Ruta Aukstakalniene, Zivile Teberaite, Erika Salciute, Renatas Tikuisis, Povilas Miliauskas, Sipylaite Jurate, Egle Kontrimaviciute, Gabija Tomkute, John Xuereb, Maureen Bezzina, Francis Joseph Borg, Sabrine Hemmes, Marcus Schultz, Markus Hollmann, Irene Wiersma, Jan Binnekade, Lieuwe Bos, Christa Boer, Anne Duvekot, Bas In 'T Veld, Alice Werger, Paul Dennesen, Charlotte Severijns, Jasper De Jong, Jens Hering, Rienk Van Beek, Stefan Ivars, Ib Jammer, Alena Breidablik, Katharina Skirstad Hodt, Frode Fjellanger, Manuel Vico Avalos, Jannicke Mellin-Olsen, Elisabeth Andersson, Amir Shafi-Kabiri, Ruby Molina, Stanley Wutai, Erick Morais, Glória Tareco, Daniel Ferreira, Joana Amaral, Maria De Lurdes Goncalves Castro, Susana Cadilha, Sofia Appleton, Suzana Parente, Mariana Correia, Diogo Martins, Angela Monteirosa, Ana Ricardo, Sara Rodrigues, Lucian Horhota, Ioana Marina Grintescu, Liliana Mirea, Ioana Cristina Grintescu, Dan Corneci, Silvius Negoita, Madalina Dutu, Ioana Popescu Garotescu, Daniela Filipescu, Alexandru Bogdan Prodan, Gabriela Droc, Ruxandra Fota, Mihai Popescu, Dana Tomescu, Ana Maria Petcu, Marian Irinel Tudoroiu, Alida Moise, Catalin Traian Guran, Iorel Gherghina, Dan Costea, Iulia Cindea, Sanda Maria Copotoiu, Ruxandra Copotoiu, Victoria Barsan, Zsolt Tolcser, Magda Riciu, Septimiu Gheorghe Moldovan, Mihaly Veres, Alexey Gritsan, Tatyana Kapkan, Galina Gritsan, Oleg Korolkov, Alexander Kulikov, Andrey Lubnin, Alexey Ovezov, Pavel Prokoshev, Alexander Lugovoy, Natalia Anipchenko, Andrey Babayants, Irina Komissarova, Karginova Zalina, Valery Likhvantsev, Sergei Fedorov, Aleksandra Lazukic, Jasmina Pejakovic, Dunja Mihajlovic, Zuzana Kusnierikova, Maria Zelinkova, Katarina Bruncakova, Lenka Polakovicova, Villiam Sobona, Barbka Novak-Supe, Ana Pekle-Golez, Miroljub Jovanov, Branka Strazisar, Jasmina Markovic-Bozic, Vesna Novak-Jankovic, Minca Voje, Andriy Grynyuk, Ivan Kostadinov, Alenka Spindler-Vesel, Victoria Moral, Mari Carmen Unzueta, Carlos Puigbo, Josep Fava, Jaume Canet, Enrique Moret, Mónica Rodriguez Nunez, Mar Sendra, Andrea Brunelli, Frederic Rodenas, Pablo Monedero, Francisco Hidalgo Martinez, Maria Jose Yepes Temino, Antonio Martínez Simon, Ana De Abajo Larriba, Alberto Lisi, Gisela Perez, Raquel Martinez, Manuel Granell, Jose Tatay Vivo, Cristina Saiz Ruiz, Jose Antonio De Andrés Ibañez, Ernesto Pastor, Marina Soro, Carlos Ferrando, Mario Defez, Cesar Aldecoa Alvares-Santullano, Rocio Perez, Jesus Rico, Monir Jawad, Yousif Saeed, Lars Gillberg, Zuleyha Kazak Bengisun, Baturay Kansu Kazbek, Nesil Coskunfirat, Neval Boztug, Suat Sanli, Murat Yilmaz, Necmiye Hadimioglu, Nuzhet Mert Senturk, Emre Camci, Semra Kucukgoncu, Zerrin Sungur, Nukhet Sivrikoz, Serpil Ustalar Ozgen, Fevzi Toraman, Onur Selvi, Ozgur Senturk, Mine Yildiz, Bahar Kuvaki, Ferim Gunenc, Semih Kucukguclu, Şule Ozbilgin, Jale Maral, Seyda Canli, Oguzhan Arun, Ali Saltali, Eyup Aydogan, Fatma Nur Akgun, Ceren Sanlikarip, Fatma Mine Karaman, Andriy Mazur, Sergiy Vorotyntsev, Guy Rousseau, Colin Barrett, Lucia Stancombe, Ben Shelley, Helen Scholes, James Limb, Amir Rafi, Lisa Wayman, Jill Deane, David Rogerson, John Williams, Susan Yates, Elaine Rogers, Mark Pulletz, Sarah Moreton, Stephanie Jones, Suresh Venkatesh, Maudrian Burton, Lucy Brown, Cait Goodall, Matthew Rucklidge, Debbie Fuller, Maria Nadolski, Sandeep Kusre, Michael Lundberg, Lynn Everett, Helen Nutt, Maka Zuleika, Peter Carvalho, Deborah Clements, Ben Creagh-Brown, Philip Watt, Parizade Raymode, Rupert Pearse, Otto Mohr, Ashok Raj, Thais Creary, Ahmed Chishti, Andrea Bell, Charley Higham, Alistair Cain, Sarah Gibb, Stephen Mowat, Danielle Franklin, Claire West, Gary Minto, Nicholas Boyd, Gary Mills, Emily Calton, Rachel Walker, Felicity Mackenzie, Branwen Ellison, Helen Roberts, Moses Chikungwa, Clare Jackson, Andrew Donovan, Jayne Foot, Elizabeth Homan, Jane Montgomery, David Portch, Pauline Mercer, Janet Palmer, Jonathan Paddle, Anna Fouracres, Amanda Datson, Alyson Andrew, Leanne Welch, Alastair Rose, Sandeep Varma, Karen Simeson, Mrutyunjaya Rambhatla, Jaysimha Susarla, Sudhakar Marri, Krishnan Kodaganallur, Ashok Das, Shivarajan Algarsamy, Julie Colley, Simon Davies, Margaret Szewczyk, Thomas Smith, Ana Fernandez-Bustamante, Elizabeth Luzier, Angela Almagro, Marcos Vidal Melo, Luiz Fernando, Demet Sulemanji, Juraj Sprung, Toby Weingarten, Daryl Kor, Federica Scavonetto, Yeo Tze

Research output: Contribution to journalArticle

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 (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.

Original languageEnglish (US)
Article number73
JournalBMC Anesthesiology
Volume20
Issue number1
DOIs
StatePublished - Apr 2 2020

Keywords

  • LAS VEGAS
  • Mechanical ventilation
  • Neurosurgery
  • Postoperative pulmonary complications

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Robba, C., Hemmes, S. N. T., Serpa Neto, A., Bluth, T., Canet, J., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Putensen, C., Jaber, S., Schmid, W., Severgnini, P., Wrigge, H., Battaglini, D., Ball, L., Gama De Abreu, M., Schultz, M. J., Pelosi, P., ... Tze, Y. (2020). Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: Post-hoc analysis of LAS VEGAS study. BMC Anesthesiology, 20(1), [73]. https://doi.org/10.1186/s12871-020-00988-x