Sex difference and intra-operative tidal volume Insights from
the LAS VEGAS study

J 2021

Sex difference and intra-operative tidal volume Insights from the LAS VEGAS study

NIJBROEK, SG, L HOL, P SWART, SNT HEMMES, AS NETO et. al.

Základní údaje

Originální název

Sex difference and intra-operative tidal volume Insights from the LAS VEGAS study

Autoři

Vydání

European Journal of Anaesthesiology, Philadelphia, Lippincott Williams & Wilkins, 2021, 0265-0215

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 4.183

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1097/EJA.0000000000001476

UT WoS

000693373000005

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 28. 4. 2022 14:39, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND One key element of lung-protective ventilation is the use of a low tidal volume (V-T). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES Women and men were compared with respect to use of LTVV, defined as V-T of 8 ml kg(-1) or less predicted bodyweight (PBW). A V-T was deemed 'default' if the set V-T was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS This analysis includes 9864 patients, of whom 5425 (55%) were women. A default V-T was often set, both in women and men; mode V-T was 500 ml. Median [IQR] V-T was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg(-1) PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default V-T. CONCLUSION In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher V-T than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.

Citovat

NIJBROEK, SG, L HOL, P SWART, SNT HEMMES, AS NETO, JM BINNEKADE, G HEDENSTIERNA, S JABER, M HIESMAYR, MW HOLLMANN, GH MILLS, MFV MELO, C PUTENSEN, W SCHMID, P SEVERGNINI, H WRIGGE, Abreu MG DE, P PELOSI a MJ SCHULTZ. Sex difference and intra-operative tidal volume Insights from the LAS VEGAS study. European Journal of Anaesthesiology. Philadelphia: Lippincott Williams & Wilkins, 2021, roč. 38, č. 10, s. 1034-1041. ISSN 0265-0215. Dostupné z: https://dx.doi.org/10.1097/EJA.0000000000001476.

@article{1833317,
   author = {Nijbroek, SG and Hol, L and Swart, P and Hemmes, SNT and Neto, AS and Binnekade, JM and Hedenstierna, G and Jaber, S and Hiesmayr, M and Hollmann, MW and Mills, GH and Melo, MFV and Putensen, C and Schmid, W and Severgnini, P and Wrigge, H and de, Abreu MG and Pelosi, P and Schultz, MJ and Štourač, Petr},
   article_location = {Philadelphia},
   article_number = {10},
   doi = {http://dx.doi.org/10.1097/EJA.0000000000001476},
   language = {eng},
   issn = {0265-0215},
   journal = {European Journal of Anaesthesiology},
   title = {Sex difference and intra-operative tidal volume Insights from the LAS VEGAS study},
   volume = {38},
   year = {2021}
}

TY  - JOUR
ID  - 1833317
AU  - Nijbroek, SG - Hol, L - Swart, P - Hemmes, SNT - Neto, AS - Binnekade, JM - Hedenstierna, G - Jaber, S - Hiesmayr, M - Hollmann, MW - Mills, GH - Melo, MFV - Putensen, C - Schmid, W - Severgnini, P - Wrigge, H - de, Abreu MG - Pelosi, P - Schultz, MJ - Štourač, Petr
PY  - 2021
TI  - Sex difference and intra-operative tidal volume Insights from the LAS VEGAS study
JF  - European Journal of Anaesthesiology
VL  - 38
IS  - 10
SP  - 1034-1041
EP  - 1034-1041
PB  - Lippincott Williams & Wilkins
SN  - 02650215
N2  - BACKGROUND One key element of lung-protective ventilation is the use of a low tidal volume (V-T). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES Women and men were compared with respect to use of LTVV, defined as V-T of 8 ml kg(-1) or less predicted bodyweight (PBW). A V-T was deemed 'default' if the set V-T was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS This analysis includes 9864 patients, of whom 5425 (55%) were women. A default V-T was often set, both in women and men; mode V-T was 500 ml. Median [IQR] V-T was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg(-1) PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default V-T. CONCLUSION In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher V-T than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.
ER  -

NIJBROEK, SG, L HOL, P SWART, SNT HEMMES, AS NETO, JM BINNEKADE, G HEDENSTIERNA, S JABER, M HIESMAYR, MW HOLLMANN, GH MILLS, MFV MELO, C PUTENSEN, W SCHMID, P SEVERGNINI, H WRIGGE, Abreu MG DE, P PELOSI a MJ SCHULTZ. Sex difference and intra-operative tidal volume Insights from the LAS VEGAS study. \textit{European Journal of Anaesthesiology}. Philadelphia: Lippincott Williams \&{} Wilkins, 2021, roč.~38, č.~10, s.~1034-1041. ISSN~0265-0215. Dostupné z: https://dx.doi.org/10.1097/EJA.0000000000001476.

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