The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.


Journal

BMC anesthesiology
ISSN: 1471-2253
Titre abrégé: BMC Anesthesiol
Pays: England
ID NLM: 100968535

Informations de publication

Date de publication:
19 03 2021
Historique:
received: 12 11 2020
accepted: 25 01 2021
entrez: 20 3 2021
pubmed: 21 3 2021
medline: 29 12 2021
Statut: epublish

Résumé

It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average ΔP (ΔP Posthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔP ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223 ).

Sections du résumé

BACKGROUND
It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average ΔP (ΔP
METHODS
Posthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events.
RESULTS
The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔP
CONCLUSIONS
ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery.
TRIAL REGISTRATION
LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223 ).

Identifiants

pubmed: 33740885
doi: 10.1186/s12871-021-01268-y
pii: 10.1186/s12871-021-01268-y
pmc: PMC7977277
doi:

Banques de données

ClinicalTrials.gov
['NCT01601223']

Types de publication

Journal Article Multicenter Study Observational Study Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

84

Subventions

Organisme : NHLBI NIH HHS
ID : UH3 HL140177
Pays : United States

Investigateurs

Wolfgang Kroell (W)
Helfried Metzler (H)
Gerd Struber (G)
Thomas Wegscheider (T)
Hans Gombotz (H)
Michael Hiesmayr (M)
Werner Schmid (W)
Bernhard Urbanek (B)
David Kahn (D)
Mona Momeni (M)
Audrey Pospiech (A)
Fernande Lois (F)
Patrice Forget (P)
Irina Grosu (I)
Jan Poelaert (J)
Veerle van Mossevelde (V)
Marie-Claire van Malderen (MC)
Dimitri Dylst (D)
Jeroen van Melkebeek (J)
Maud Beran (M)
Stefan de Hert (S)
Luc De Baerdemaeker (L)
Bjorn Heyse (B)
Jurgen Van Limmen (J)
Piet Wyffels (P)
Tom Jacobs (T)
Nathalie Roels (N)
Ann De Bruyne (A)
Stijn van de Velde (S)
Brigitte Leva (B)
Sandrine Damster (S)
Benoit Plichon (B)
Marina Juros-Zovko (M)
Dejana Djonoviċ-Omanoviċ (D)
Selma Pernar (S)
Josip Zunic (J)
Petar Miskovic (P)
Antonio Zilic (A)
Slavica Kvolik (S)
Dubravka Ivic (D)
Darija Azenic-Venzera (D)
Sonja Skiljic (S)
Hrvoje Vinkovic (H)
Ivana Oputric (I)
Kazimir Juricic (K)
Vedran Frkovic (V)
Jasminka Kopic (J)
Ivan Mirkovic (I)
Nenad Karanovic (N)
Mladen Carev (M)
Natasa Dropulic (N)
Jadranka Pavicic Saric (JP)
Gorjana Erceg (G)
Matea Bogdanovic Dvorscak (MB)
Branka Mazul-Sunko (B)
Anna Marija Pavicic (AM)
Tanja Goranovic (T)
Branka Maldini (B)
Tomislav Radocaj (T)
Zeljka Gavranovic (Z)
Inga Mladic-Batinica (I)
Mirna Sehovic (M)
Petr Stourac (P)
Hana Harazim (H)
Olga Smekalova (O)
Martina Kosinova (M)
Tomas Kolacek (T)
Kamil Hudacek (K)
Michal Drab (M)
Jan Brujevic (J)
Katerina Vitkova (K)
Katerina Jirmanova (K)
Ivana Volfova (I)
Paula Dzurnakova (P)
Katarina Liskova (K)
Radovan Dudas (R)
Radek Filipsky (R)
Samir El Kafrawy (S)
Hisham Hosny Abdelwahab (HH)
Tarek Metwally (T)
Ahmed Abdel-Razek (A)
Ahmed Mostafa El-Shaarawy (AM)
Wael Fathy Hasan (WF)
Ahmed Gouda Ahmed (AG)
Hany Yassin (H)
Mohamed Magdy (M)
Mahdy Abdelhady (M)
Mohamed Mahran (M)
Eiko Herodes (E)
Peeter Kivik (P)
Juri Oganjan (J)
Annika Aun (A)
Alar Sormus (A)
Kaili Sarapuu (K)
Merilin Mall (M)
Juri Karjagin (J)
Emmanuel Futier (E)
Antoine Petit (A)
Adeline Gerard (A)
Emmanuel Marret (E)
Marc Solier (M)
Samir Jaber (S)
Albert Prades (A)
Jens Krassler (J)
Simone Merzky (S)
Marcel Gama de Abreu (MG)
Christopher Uhlig (C)
Thomas Kiss (T)
Anette Bundy (A)
Thomas Bluth (T)
Andreas Gueldner (A)
Peter Spieth (P)
Martin Scharffenberg (M)
Denny Tran Thiem (DT)
Thea Koch (T)
Tanja Treschan (T)
Maximilian Schaefer (M)
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Martin Weiss (M)
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Hermann Wrigge (H)
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Auteurs

Guido Mazzinari (G)

Research Group in Perioperative Medicine, Hospital Universitario y Politécnico la Fe, Avinguda de Fernando Abril Martorell 106, 46026, Valencia, Spain. gmazzinari@gmail.com.
Department of Anesthesiology, Hospital Universitario y Politécnico la Fe, Valencia, Spain. gmazzinari@gmail.com.

Ary Serpa Neto (A)

Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Cardio-Pulmonary Department, Pulmonary Division, Faculdade de Medicina, Instituto do Coração, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Center, Amsterdam, The Netherlands.

Sabrine N T Hemmes (SNT)

Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Center, Amsterdam, The Netherlands.

Goran Hedenstierna (G)

Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.

Samir Jaber (S)

PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, Montpellier, France.

Michael Hiesmayr (M)

Division Cardiac, Thoracic, Vascular Anesthesia and Intensive Care, Medical University Vienna, Vienna, Austria.

Markus W Hollmann (MW)

Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Center, Amsterdam, The Netherlands.

Gary H Mills (GH)

Operating Services, Critical Care and Anesthesia, Sheffield Teaching Hospitals, Sheffield and University of Sheffield, Sheffield, UK.

Marcos F Vidal Melo (MF)

Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, USA.

Rupert M Pearse (RM)

Queen Mary University of London, London, UK.

Christian Putensen (C)

Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.

Werner Schmid (W)

Division Cardiac, Thoracic, Vascular Anesthesia and Intensive Care, Medical University Vienna, Vienna, Austria.

Paolo Severgnini (P)

Department of Biotechnology and Sciences of Life, ASST- Settelaghi Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.

Hermann Wrigge (H)

Department of Anesthesiology, Intensive Care and Emergency Medicine, Pain Therapy, Bergmannstrost Hospital, Halle, Germany.

Oscar Diaz Cambronero (OD)

Research Group in Perioperative Medicine, Hospital Universitario y Politécnico la Fe, Avinguda de Fernando Abril Martorell 106, 46026, Valencia, Spain.
Department of Anesthesiology, Hospital Universitario y Politécnico la Fe, Valencia, Spain.

Lorenzo Ball (L)

Policlinico San Martino Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
Department of Surgical Sciences and Integrated Diagnostics, University of Genoa Italy, Genoa, Italy.

Marcelo Gama de Abreu (MG)

Department of Anesthesiology and Intensive Care Therapy, Pulmonary Engineering Group, Technische Universität Dresden, Dresden, Germany.

Paolo Pelosi (P)

Policlinico San Martino Hospital - IRCCS for Oncology and Neurosciences, Genoa, Italy.
Department of Surgical Sciences and Integrated Diagnostics, University of Genoa Italy, Genoa, Italy.

Marcus J Schultz (MJ)

Department of Intensive Care & Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Academic Medical Center, Amsterdam, The Netherlands.
Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand.
Nuffield Department of Medicine, University of Oxford, Oxford, UK.

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