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- Publisher Website: 10.1111/anae.14039
- Scopus: eid_2-s2.0-85029234651
- PMID: 28891046
- WOS: WOS:000413402600007
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Article: The association of postoperative pulmonary complications in 109,360 patients with pressure-controlled or volume-controlled ventilation
Title | The association of postoperative pulmonary complications in 109,360 patients with pressure-controlled or volume-controlled ventilation |
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Authors | |
Keywords | Lung protection ventilation: pressure goal Pressure‐controlled ventilation Volume‐controlled ventilation |
Issue Date | 2017 |
Publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044 |
Citation | Anaesthesia, 2017, v. 72 n. 11, p. 1334-1343 How to Cite? |
Abstract | We thought that the rate of postoperative pulmonary complications might be higher after pressure‐controlled ventilation than after volume‐controlled ventilation. We analysed peri‐operative data recorded for 109,360 adults, whose lungs were mechanically ventilated during surgery at three hospitals in Massachusetts, USA. We used multivariable regression and propensity score matching. Postoperative pulmonary complications were more common after pressure‐controlled ventilation, odds ratio (95%CI) 1.29 (1.21–1.37), p < 0.001. Tidal volumes and driving pressures were more varied with pressure‐controlled ventilation compared with volume‐controlled ventilation: mean (SD) variance from the median 1.61 (1.36) ml.kg−1 vs. 1.23 (1.11) ml.kg−1, p < 0.001; and 3.91 (3.47) cmH2O vs. 3.40 (2.69) cmH2O, p < 0.001. The odds ratio (95%CI) of pulmonary complications after pressure‐controlled ventilation compared with volume‐controlled ventilation at positive end‐expiratory pressures < 5 cmH2O was 1.40 (1.26–1.55) and 1.20 (1.11–1.31) when ≥ 5 cmH2O, both p < 0.001, a relative risk ratio of 1.17 (1.03–1.33), p = 0.023. The odds ratio (95%CI) of pulmonary complications after pressure‐controlled ventilation compared with volume‐controlled ventilation at driving pressures of < 19 cmH2O was 1.37 (1.27–1.48), p < 0.001, and 1.16 (1.04–1.30) when ≥ 19 cmH2O, p = 0.011, a relative risk ratio of 1.18 (1.07–1.30), p = 0.016. Our data support volume‐controlled ventilation during surgery, particularly for patients more likely to suffer postoperative pulmonary complications. |
Persistent Identifier | http://hdl.handle.net/10722/273494 |
ISSN | 2023 Impact Factor: 7.5 2023 SCImago Journal Rankings: 2.400 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Bagchi, A | - |
dc.contributor.author | Rudolph, MI | - |
dc.contributor.author | Ng, PY | - |
dc.contributor.author | Timm, FP | - |
dc.contributor.author | Long, DR | - |
dc.contributor.author | Shaefi, S | - |
dc.contributor.author | Ladha, K | - |
dc.contributor.author | Vidal Melo, MF | - |
dc.contributor.author | Eikermann, M | - |
dc.date.accessioned | 2019-08-12T03:14:49Z | - |
dc.date.available | 2019-08-12T03:14:49Z | - |
dc.date.issued | 2017 | - |
dc.identifier.citation | Anaesthesia, 2017, v. 72 n. 11, p. 1334-1343 | - |
dc.identifier.issn | 0003-2409 | - |
dc.identifier.uri | http://hdl.handle.net/10722/273494 | - |
dc.description.abstract | We thought that the rate of postoperative pulmonary complications might be higher after pressure‐controlled ventilation than after volume‐controlled ventilation. We analysed peri‐operative data recorded for 109,360 adults, whose lungs were mechanically ventilated during surgery at three hospitals in Massachusetts, USA. We used multivariable regression and propensity score matching. Postoperative pulmonary complications were more common after pressure‐controlled ventilation, odds ratio (95%CI) 1.29 (1.21–1.37), p < 0.001. Tidal volumes and driving pressures were more varied with pressure‐controlled ventilation compared with volume‐controlled ventilation: mean (SD) variance from the median 1.61 (1.36) ml.kg−1 vs. 1.23 (1.11) ml.kg−1, p < 0.001; and 3.91 (3.47) cmH2O vs. 3.40 (2.69) cmH2O, p < 0.001. The odds ratio (95%CI) of pulmonary complications after pressure‐controlled ventilation compared with volume‐controlled ventilation at positive end‐expiratory pressures < 5 cmH2O was 1.40 (1.26–1.55) and 1.20 (1.11–1.31) when ≥ 5 cmH2O, both p < 0.001, a relative risk ratio of 1.17 (1.03–1.33), p = 0.023. The odds ratio (95%CI) of pulmonary complications after pressure‐controlled ventilation compared with volume‐controlled ventilation at driving pressures of < 19 cmH2O was 1.37 (1.27–1.48), p < 0.001, and 1.16 (1.04–1.30) when ≥ 19 cmH2O, p = 0.011, a relative risk ratio of 1.18 (1.07–1.30), p = 0.016. Our data support volume‐controlled ventilation during surgery, particularly for patients more likely to suffer postoperative pulmonary complications. | - |
dc.language | eng | - |
dc.publisher | Wiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2044 | - |
dc.relation.ispartof | Anaesthesia | - |
dc.subject | Lung protection ventilation: pressure goal | - |
dc.subject | Pressure‐controlled ventilation | - |
dc.subject | Volume‐controlled ventilation | - |
dc.title | The association of postoperative pulmonary complications in 109,360 patients with pressure-controlled or volume-controlled ventilation | - |
dc.type | Article | - |
dc.identifier.email | Ng, PY: pyeungng@hku.hk | - |
dc.identifier.authority | Ng, PY=rp02517 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1111/anae.14039 | - |
dc.identifier.pmid | 28891046 | - |
dc.identifier.scopus | eid_2-s2.0-85029234651 | - |
dc.identifier.hkuros | 300649 | - |
dc.identifier.volume | 72 | - |
dc.identifier.issue | 11 | - |
dc.identifier.spage | 1334 | - |
dc.identifier.epage | 1343 | - |
dc.identifier.isi | WOS:000413402600007 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0003-2409 | - |