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 language | English (US) |
|---|---|
| Article number | 73 |
| Journal | BMC Anesthesiology |
| Volume | 20 |
| Issue number | 1 |
| DOIs | |
| State | Published - Apr 2 2020 |
Keywords
- LAS VEGAS
- Mechanical ventilation
- Neurosurgery
- Postoperative pulmonary complications
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
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Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients : Post-hoc analysis of LAS VEGAS study. / Robba, Chiara; Hemmes, Sabrine N.T.; Serpa Neto, Ary et al.
In: BMC Anesthesiology, Vol. 20, No. 1, 73, 02.04.2020.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients
T2 - Post-hoc analysis of LAS VEGAS study
AU - Robba, Chiara
AU - Hemmes, Sabrine N.T.
AU - Serpa Neto, Ary
AU - Bluth, Thomas
AU - Canet, Jaume
AU - Hiesmayr, Michael
AU - Hollmann, M. Wiersma
AU - Mills, Gary H.
AU - Vidal Melo, Marcos F.
AU - Putensen, Christian
AU - Jaber, Samir
AU - Schmid, Werner
AU - Severgnini, Paolo
AU - Wrigge, Hermann
AU - Battaglini, Denise
AU - Ball, Lorenzo
AU - Gama De Abreu, Marcelo
AU - Schultz, Marcus J.
AU - Pelosi, Paolo
AU - Kroell, Wolfgang
AU - Metzler, Helfried
AU - Struber, Gerd
AU - Wegscheider, Thomas
AU - Gombotz, Hans
AU - Hiesmayr, Michael
AU - Schmid, Werner
AU - Urbanek, Bernhard
AU - Kahn, David
AU - Momeni, Mona
AU - Pospiech, Audrey
AU - Lois, Fernande
AU - Forget, Patrice
AU - Grosu, Irina
AU - Poelaert, Jan
AU - Van Mossevelde, Veerle
AU - Van Malderen, Marie Claire
AU - Dylst, Dimitri
AU - Van Melkebeek, Jeroen
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AU - De Hert, Stefan
AU - De Baerdemaeker, Luc
AU - Heyse, Bjorn
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AU - Wyffels, Piet
AU - Jacobs, Tom
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AU - Karanovic, Nenad
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AU - Temino, Maria Jose Yepes
AU - Simon, Antonio Martínez
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AU - Martinez, Raquel
AU - Granell, Manuel
AU - Vivo, Jose Tatay
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AU - Ferrando, Carlos
AU - Defez, Mario
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AU - Moreton, Sarah
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AU - Brown, Lucy
AU - Goodall, Cait
AU - Rucklidge, Matthew
AU - Fuller, Debbie
AU - Nadolski, Maria
AU - Kusre, Sandeep
AU - Lundberg, Michael
AU - Everett, Lynn
AU - Nutt, Helen
AU - Zuleika, Maka
AU - Carvalho, Peter
AU - Clements, Deborah
AU - Creagh-Brown, Ben
AU - Watt, Philip
AU - Raymode, Parizade
AU - Pearse, Rupert
AU - Mohr, Otto
AU - Raj, Ashok
AU - Creary, Thais
AU - Chishti, Ahmed
AU - Bell, Andrea
AU - Higham, Charley
AU - Cain, Alistair
AU - Gibb, Sarah
AU - Mowat, Stephen
AU - Franklin, Danielle
AU - West, Claire
AU - Minto, Gary
AU - Boyd, Nicholas
AU - Calton, Emily
AU - Walker, Rachel
AU - Mackenzie, Felicity
AU - Ellison, Branwen
AU - Roberts, Helen
AU - Chikungwa, Moses
AU - Jackson, Clare
AU - Donovan, Andrew
AU - Foot, Jayne
AU - Homan, Elizabeth
AU - Montgomery, Jane
AU - Portch, David
AU - Mercer, Pauline
AU - Palmer, Janet
AU - Paddle, Jonathan
AU - Fouracres, Anna
AU - Datson, Amanda
AU - Andrew, Alyson
AU - Welch, Leanne
AU - Rose, Alastair
AU - Varma, Sandeep
AU - Simeson, Karen
AU - Rambhatla, Mrutyunjaya
AU - Susarla, Jaysimha
AU - Marri, Sudhakar
AU - Kodaganallur, Krishnan
AU - Das, Ashok
AU - Algarsamy, Shivarajan
AU - Colley, Julie
AU - Davies, Simon
AU - Szewczyk, Margaret
AU - Smith, Thomas
AU - Fernandez-Bustamante, Ana
AU - Luzier, Elizabeth
AU - Almagro, Angela
AU - Melo, Marcos Vidal
AU - Fernando, Luiz
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N1 - 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).
PY - 2020/4/2
Y1 - 2020/4/2
N2 - 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.
AB - 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.
KW - LAS VEGAS
KW - Mechanical ventilation
KW - Neurosurgery
KW - Postoperative pulmonary complications
UR - http://www.scopus.com/inward/record.url?scp=85082895096&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082895096&partnerID=8YFLogxK
U2 - 10.1186/s12871-020-00988-x
DO - 10.1186/s12871-020-00988-x
M3 - Article
C2 - 32241266
AN - SCOPUS:85082895096
SN - 1471-2253
VL - 20
JO - BMC Anesthesiology
JF - BMC Anesthesiology
IS - 1
M1 - 73
ER -