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

J 2021

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

MAZZINARI, G, AS NETO, SNT HEMMES, G HEDENSTIERNA, S JABER et. al.

Základní údaje

Originální název

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

Autoři

Vydání

BMC Anesthesiology, London, BMC, 2021, 1471-2253

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 2.376

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1186/s12871-021-01268-y

UT WoS

000631503200002

Klíčová slova anglicky

Pneumoperitoneum; Laparoscopy; Laparoscopic surgery; Perioperative ventilation; Protective ventilation; PEEP; Respiratory mechanics; Driving pressure

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 29. 4. 2022 08:27, Mgr. Tereza Miškechová

Anotace

V originále

Background It is uncertain whether the association of the intraoperative driving pressure (Delta P) 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 Delta P (Delta P-TW) with PPCs. We also tested the association of Delta P-TW with intraoperative adverse events. 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%. Delta P was lower in open abdominal surgery patients, but Delta P-TW was not different between groups. The association of Delta P-TW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of Delta P-TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001).Conclusions Delta P is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery.Trial registrationLAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).

Citovat

MAZZINARI, G, AS NETO, SNT HEMMES, G HEDENSTIERNA, S JABER, M HIESMAYR, MW HOLLMANN, GH MILLS, MFV MELO, RM PEARSE, C PUTENSEN, W SCHMID, P SEVERGNINI, H WRIGGE, OD CAMBRONERO, L BALL, Abreu MG DE, P PELOSI, MJ SCHULTZ, Petr ŠTOURAČ, Hana HARAZIM, Olga SMÉKALOVÁ, Martina KOSINOVÁ, tomáš KOLÁČEK, Kamil HUDÁČEK a Michal DRÁB. 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. BMC Anesthesiology. London: BMC, 2021, roč. 21, č. 1, 15 s. ISSN 1471-2253. Dostupné z: https://dx.doi.org/10.1186/s12871-021-01268-y.

@article{1833320,
   author = {Mazzinari, G and Neto, AS and Hemmes, SNT and Hedenstierna, G and Jaber, S and Hiesmayr, M and Hollmann, MW and Mills, GH and Melo, MFV and Pearse, RM and Putensen, C and Schmid, W and Severgnini, P and Wrigge, H and Cambronero, OD and Ball, L and de, Abreu MG and Pelosi, P and Schultz, MJ and Štourač, Petr and Harazim, Hana and Smékalová, Olga and Kosinová, Martina and koláček, tomáš and Hudáček, Kamil and Dráb, Michal},
   article_location = {London},
   article_number = {1},
   doi = {http://dx.doi.org/10.1186/s12871-021-01268-y},
   keywords = {Pneumoperitoneum; Laparoscopy; Laparoscopic surgery; Perioperative ventilation; Protective ventilation; PEEP; Respiratory mechanics; Driving pressure},
   language = {eng},
   issn = {1471-2253},
   journal = {BMC Anesthesiology},
   title = {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},
   volume = {21},
   year = {2021}
}

TY  - JOUR
ID  - 1833320
AU  - Mazzinari, G - Neto, AS - Hemmes, SNT - Hedenstierna, G - Jaber, S - Hiesmayr, M - Hollmann, MW - Mills, GH - Melo, MFV - Pearse, RM - Putensen, C - Schmid, W - Severgnini, P - Wrigge, H - Cambronero, OD - Ball, L - de, Abreu MG - Pelosi, P - Schultz, MJ - Štourač, Petr - Harazim, Hana - Smékalová, Olga - Kosinová, Martina - koláček, tomáš - Hudáček, Kamil - Dráb, Michal
PY  - 2021
TI  - 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
JF  - BMC Anesthesiology
VL  - 21
IS  - 1
PB  - BMC
SN  - 14712253
KW  - Pneumoperitoneum
KW  - Laparoscopy
KW  - Laparoscopic surgery
KW  - Perioperative ventilation
KW  - Protective ventilation
KW  - PEEP
KW  - Respiratory mechanics
KW  - Driving pressure
N2  - Background It is uncertain whether the association of the intraoperative driving pressure (Delta P) 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 Delta P (Delta P-TW) with PPCs. We also tested the association of Delta P-TW with intraoperative adverse events. 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%. Delta P was lower in open abdominal surgery patients, but Delta P-TW was not different between groups. The association of Delta P-TW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of Delta P-TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001).Conclusions Delta P is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery.Trial registrationLAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).
ER  -

MAZZINARI, G, AS NETO, SNT HEMMES, G HEDENSTIERNA, S JABER, M HIESMAYR, MW HOLLMANN, GH MILLS, MFV MELO, RM PEARSE, C PUTENSEN, W SCHMID, P SEVERGNINI, H WRIGGE, OD CAMBRONERO, L BALL, Abreu MG DE, P PELOSI, MJ SCHULTZ, Petr ŠTOURAČ, Hana HARAZIM, Olga SMÉKALOVÁ, Martina KOSINOVÁ, tomáš KOLÁČEK, Kamil HUDÁČEK a Michal DRÁB. 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. \textit{BMC Anesthesiology}. London: BMC, 2021, roč.~21, č.~1, 15 s. ISSN~1471-2253. Dostupné z: https://dx.doi.org/10.1186/s12871-021-01268-y.

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