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 and 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, vol. 21, No 1, 15 pp. ISSN 1471-2253. Available from: https://dx.doi.org/10.1186/s12871-021-01268-y. |
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@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 and 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, vol.~21, No~1, 15 pp. ISSN~1471-2253. Available from: https://dx.doi.org/10.1186/s12871-021-01268-y.
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