Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study

ROBBA, C, SNT HEMMES, AS NETO, T BLUTH, J CANET, M HIESMAYR, MW HOLLMANN, GH MILLS, MFV MELO, C PUTENSEN, S JABER, W SCHMID, P SEVERGNINI, H WRIGGE, D BATTAGLINI, L BALL, Abreu MG DE, MJ SCHULTZ, P PELOSI, Petr ŠTOURAČ, Hana HARAZIM, Olga SMÉKALOVÁ, Martina KOSINOVÁ, tomas KOLACEK and Kamil HUDÁČEK. Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study. BMC Anesthesiology. London: BMC, 2020, vol. 20, No 1, 14 pp. ISSN 1471-2253. Available from: https://dx.doi.org/10.1186/s12871-020-00988-x.

Basic information

• Original name: Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study
• Authors: ROBBA, C, SNT HEMMES, AS NETO, T BLUTH, J CANET, M HIESMAYR, MW HOLLMANN, GH MILLS, MFV MELO, C PUTENSEN, S JABER, W SCHMID, P SEVERGNINI, H WRIGGE, D BATTAGLINI, L BALL, Abreu MG DE, MJ SCHULTZ, P PELOSI, Petr ŠTOURAČ, Hana HARAZIM, Olga SMÉKALOVÁ, Martina KOSINOVÁ, tomas KOLACEK and Kamil HUDÁČEK.
• Edition: BMC Anesthesiology, London, BMC, 2020, 1471-2253.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Confidentiality degree: is not subject to a state or trade secret
• Impact factor: Impact factor: 2.217
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1186/s12871-020-00988-x
• UT WoS: 000523482700002
• Keywords in English: LAS VEGAS; Mechanical ventilation; Postoperative pulmonary complications; Neurosurgery
• Tags: International impact, Reviewed

Abstract

Background Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (V-T) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH(2)0. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions Neurosurgical patients are ventilated with low V-T and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs.