High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial.
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TLDR
A strategy with a high level of positive end-expiratory pressure and recruitment manoeuvres during open abdominal surgery does not protect against postoperative pulmonary complications, and an intraoperative protective ventilation strategy should include a low tidal volume and low positiveEnd-expiration pressure, without recruitment manoeuvre.About:
This article is published in The Lancet.The article was published on 2014-08-09 and is currently open access. It has received 516 citations till now. The article focuses on the topics: Positive end-expiratory pressure & Mechanical ventilation.read more
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Journal ArticleDOI
Postoperative pulmonary complications
A Miskovic,Andrew B Lumb +1 more
TL;DR: Preoperative optimization of co-morbidities, smoking cessation, and correction of anaemia, in addition to intraoperative protective ventilation strategies and appropriate management of neuromuscular blocking drugs, reduces PPCs.
Journal ArticleDOI
Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data.
Ary Serpa Neto,Sabrine N.T. Hemmes,Carmen Silvia Valente Barbas,Martin Beiderlinden,Ana Fernandez-Bustamante,Emmanuel Futier,Ognjen Gajic,Mohamed R. El-Tahan,Abdulmohsin A.Al Ghamdi,Ersin Günay,Samir Jaber,Serdar Kokulu,Alf Kozian,Marc Licker,Wen Qian Lin,Andrew Maslow,Stavros G. Memtsoudis,Dinis dos Reis Miranda,Pierre Moine,Thomas Ng,Domenico Paparella,V. Marco Ranieri,V. Marco Ranieri,Federica Scavonetto,Thomas F. Schilling,Gabriele Selmo,Paolo Severgnini,Juraj Sprung,Sugantha Sundar,Daniel Talmor,Tanja A. Treschan,Carmen Unzueta,Toby N. Weingarten,Esther K. Wolthuis,Hermann Wrigge,Marcelo B. P. Amato,Eduardo L. V. Costa,Marcelo Gama de Abreu,Paolo Pelosi,Marcus J. Schultz +39 more
TL;DR: In patients having surgery, intraoperative high driving pressure and changes in the level of PEEP that result in an increase of driving pressure are associated with more postoperative pulmonary complications, and a randomised controlled trial comparing ventilation based on driving pressure with usual care is needed to confirm these findings.
Journal ArticleDOI
Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery: A Multicenter Study by the Perioperative Research Network Investigators
Ana Fernandez-Bustamante,Gyorgy Frendl,Juraj Sprung,Daryl J. Kor,Bala Subramaniam,Ricardo Martinez Ruiz,Jae-Woo Lee,William G. Henderson,Angela Moss,Nitin Mehdiratta,Megan M. Colwell,Karsten Bartels,Kerstin Kolodzie,Jadelis Giquel,Marcos F. Vidal Melo +14 more
TL;DR: Patients with 1 or more PPCs, even mild, had significantly increased early postoperative mortality, intensive care unit (ICU) admission, and ICU/hospital length of stay, despite current protective ventilation practices.
Journal ArticleDOI
Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications: a comprehensive review of the role of tidal volume, positive end-expiratory pressure, and lung recruitment maneuvers.
Andreas Güldner,Thomas Kiss,Ary Serpa Neto,Sabrine N.T. Hemmes,Jaume Canet,Peter M. Spieth,Patricia Rm Rocco,Marcus J. Schultz,Paolo Pelosi,Marcelo Gama de Abreu +9 more
TL;DR: The authors propose an algorithm for protective intraoperative mechanical ventilation based on evidence from recent randomized controlled trials and the pathophysiology of ventilator-induced lung injury with emphasis on the noninjured lung.
Journal ArticleDOI
Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis
Ary Serpa Neto,Ary Serpa Neto,Sabrine N.T. Hemmes,Carmen Silvia Valente Barbas,Martin Beiderlinden,Michelle Biehl,Jan M. Binnekade,Jaume Canet,Ana Fernandez-Bustamante,Emmanuel Futier,Ognjen Gajic,Göran Hedenstierna,Markus W. Hollmann,Samir Jaber,Alf Kozian,Marc Licker,Wen Qian Lin,Andrew Maslow,Stavros G. Memtsoudis,Dinis dos Reis Miranda,Pierre Moine,Thomas Ng,Domenico Paparella,Christian Putensen,Marco Ranieri,Federica Scavonetto,Thomas F. Schilling,Werner Schmid,Gabriele Selmo,Paolo Severgnini,Juraj Sprung,Sugantha Sundar,Daniel Talmor,Tanja A. Treschan,Carmen Unzueta,Toby N. Weingarten,Esther K. Wolthuis,Hermann Wrigge,Marcelo Gama de Abreu,Paolo Pelosi,Marcus J. Schultz +40 more
TL;DR: These data support the beneficial effects of ventilation with use of low VT in patients undergoing surgery and the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.
References
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Journal ArticleDOI
Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group.
TL;DR: A 2-day consensus conference on acute renal failure (ARF) in critically ill patients was organized by ADQI as discussed by the authors, where the authors sought to review the available evidence, make recommendations and delineate key questions for future studies.
Journal ArticleDOI
An estimation of the global volume of surgery: a modelling strategy based on available data
Thomas G. Weiser,Thomas G. Weiser,Scott E. Regenbogen,Katherine D. Thompson,Alex B. Haynes,Stuart R. Lipsitz,William R. Berry,Atul A. Gawande,Atul A. Gawande +8 more
TL;DR: In view of the high death and complication rates of major surgical procedures, surgical safety should now be a substantial global public-health concern.
Journal Article
An estimation of the global volume of surgery : a modelling strategy based on available data. Commentary
Stephen W. Bickler,David Spiegel,Thomas G. Weiser,Scott E. Regenbogen,Katherine D. Thompson,Alex B. Haynes,Stuart R. Lipsitz,William R. Berry,Atul A. Gawande +8 more
TL;DR: In this paper, the authors estimated the number of major operations undertaken worldwide, described their distribution, and assessed the importance of surgical care in global public health policy, based on demographic, health, and economic data for 192 member states of the World Health Organization.
Journal ArticleDOI
Higher vs Lower Positive End-Expiratory Pressure in Patients With Acute Lung Injury and Acute Respiratory Distress Syndrome: Systematic Review and Meta-analysis
Matthias Briel,Maureen O. Meade,Alain Mercat,Roy G. Brower,Daniel Talmor,Stephen D. Walter,Arthur S. Slutsky,Eleanor Pullenayegum,Qi Zhou,Deborah J. Cook,Laurent Brochard,Jean-Christophe Richard,Francois Lamontagne,Francois Lamontagne,Neera Bhatnagar,Thomas E. Stewart,Gordon H. Guyatt +16 more
TL;DR: Evaluating the association of higher vs lower PEEP with patient-important outcomes in adults with acute lung injury or ARDS who are receiving ventilation with low tidal volumes found that higher levels were associated with improved survival among the subgroup of patients with ARDS, but lower levels were not associated withImproved hospital survival.
Journal ArticleDOI
A trial of intraoperative low-tidal-volume ventilation in abdominal surgery.
Emmanuel Futier,Jean-Michel Constantin,Catherine Paugam-Burtz,Julien Pascal,Mathilde Eurin,Arthur Neuschwander,Emmanuel Marret,Marc Beaussier,Christophe Gutton,Jean-Yves Lefrant,Bernard Allaouchiche,Daniel Verzilli,Marc Leone,Audrey De Jong,Jean-Etienne Bazin,Bruno Pereira,Samir Jaber +16 more
TL;DR: The use of a lung-protective ventilation strategy in intermediate-risk and high-risk patients undergoing major abdominal surgery was associated with improved clinical outcomes and reduced health care utilization.
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