Association between intraoperative tidal volume and postoperative respiratory complications is dependent on respiratory elastance: a retrospective, multicentre cohort study.
driving pressure
lung protective ventilation
mechanical ventilation
postoperative pulmonary complications
respiratory system elastance
tidal volume
Journal
British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
28
09
2021
revised:
18
02
2022
accepted:
05
05
2022
pubmed:
12
6
2022
medline:
27
7
2022
entrez:
11
6
2022
Statut:
ppublish
Résumé
The impact of high vs low intraoperative tidal volumes on postoperative respiratory complications remains unclear. We hypothesised that the effect of intraoperative tidal volume on postoperative respiratory complications is dependent on respiratory system elastance. We retrospectively recorded tidal volume (Vt; ml kg Overall, 10 821/197 474 (5.5%) patients sustained postoperative respiratory complications. Higher Vt was associated with greater risk of postoperative respiratory complications (adjusted odds ratio=1.42 per ml kg The association of harm with higher tidal volumes during intraoperative mechanical ventilation is modified by respiratory system elastance. These data suggest that respiratory elastance should inform the design of perioperative trials testing intraoperative ventilatory strategies.
Sections du résumé
BACKGROUND
The impact of high vs low intraoperative tidal volumes on postoperative respiratory complications remains unclear. We hypothesised that the effect of intraoperative tidal volume on postoperative respiratory complications is dependent on respiratory system elastance.
METHODS
We retrospectively recorded tidal volume (Vt; ml kg
RESULTS
Overall, 10 821/197 474 (5.5%) patients sustained postoperative respiratory complications. Higher Vt was associated with greater risk of postoperative respiratory complications (adjusted odds ratio=1.42 per ml kg
CONCLUSIONS
The association of harm with higher tidal volumes during intraoperative mechanical ventilation is modified by respiratory system elastance. These data suggest that respiratory elastance should inform the design of perioperative trials testing intraoperative ventilatory strategies.
Identifiants
pubmed: 35690489
pii: S0007-0912(22)00243-4
doi: 10.1016/j.bja.2022.05.005
pmc: PMC9837741
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
263-272Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL121228
Pays : United States
Organisme : NHLBI NIH HHS
ID : UH3 HL140177
Pays : United States
Informations de copyright
Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
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