Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study
- Authors: Robba, Chiara; Hemmes, Sabrine N T; Serpa Neto, Ary; Bluth, Thomas; Canet, Jaume; Hiesmayr, Michael; Hollmann, M Wiersma; Mills, Gary H; Vidal Melo, Marcos F; Putensen, Christian; Jaber, Samir; Schmid, Werner; Severgnini, Paolo; Wrigge, Hermann; Battaglini, Denise; Ball, Lorenzo; Gama de Abreu, Marcelo; Schultz, Marcus J; Pelosi, Paolo;Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, Van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Leva B, Damster S, Plichon B, Juros-Zovko M, Djonoviċ-Omanoviċ D, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Saric JP, Erceg G, Dvorscak MB, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Abdelwahab HH, Metwally T, Abdel-Razek A, El-Shaarawy AM, Hasan WF, Ahmed AG, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Krassler J, Merzky S, de Abreu MG, Uhlig C, Kiss T, Bundy A, Bluth T, Gueldner A, Spieth P, Scharffenberg M, Thiem DT, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, De Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Hodt KS, Fjellanger F, Avalos MV, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco G, Ferreira D, Amaral J, de Lurdes Goncalves Castro M, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Garotescu IP, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan SG, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, K
- Publication year: 2020
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/406082
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.