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@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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