Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries
In: EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 2017, S. 492-507
Online
academicJournal
Zugriff:
Background: Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. Objectives: To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. Design: This was a prospective international 1-week observational study using the 'Assess Respiratory Risk in Surgical Patients in Catalonia risk score' (ARISCAT score) for PPC for risk stratification. Patients and Setting: Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. Main Outcome Measures: The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. Results: A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T ) size was 500 ml, or 7 to 9 ml kg -1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH 2 O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. Conclusion: The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical ...
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Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries
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| Autor/in / Beteiligte Person: | Schultz, Marcus J. ; Hemmes, Sabrine N. T. ; Neto, Ary Serpa ; Binnekade, Jan M. ; Canet, Jaume ; Hedenstierna, Goran ; Jaber, Samir ; Hiesmayr, Michael ; Hollmann, Markus W. ; Mills, Gary H. ; Vidal Melo, Marcos F. ; Pearse, Rupert ; Putensen, Christian ; Schmid, Werner ; Severgnini, Paolo ; Wrigge, Hermann ; De Abreu, Marcelo Gama ; Pelosi, Paolo ; Kroell, W. ; Metzler, H. ; Struber, G. ; Wegscheider, T. ; Gombotz, H. ; Urbanek, B. ; Leva, B. ; Damster, S. ; Plichon, B. ; Kahn, D. ; Momeni, M. ; Pospiech, A. ; Lois, F. ; Forget, P. ; Grosu, I. ; Poelaert, J. ; van Mossevelde, V. ; van Malderen, M. C. ; Dylst, D. ; van Melkebeek, J. ; Beran, M. ; de Hert, S. ; De Baerdemaeker, L. ; Heyse, B. ; van Limmen, J. ; Wyffels, P. ; Jacobs, T. ; Roels, N. ; De Bruyne, A. ; van de Velde, S. ; Juros-Zovko, M. ; Djonovic-Omanovic, D. ; Pernar, S. ; Zunic, J. ; Miskovic, P. ; Zilic, A. ; Kvolik, S. ; Ivic, D. ; Azenic-Venzera, D. ; Skiljic, S. ; Vinkovic, H. ; Oputric, I. ; Juricic, K. ; Frkovic, V. ; Kopic, J. ; Mirkovic, I. ; Karanovic, N. ; Carev, M. ; Dropulic, N. ; Pavicic-Ṧaric, J. ; Erceg, G. ; Bogdanovic Dvoršcak, M. ; Mazul-Sunko, B. ; Pavicic, A. M. ; Goranovic, T. ; Maldini, B. ; Radocaj, T. ; Gavranovic, Z. ; Mladic-Batinica, I. ; Sehovic, M. ; Stourac, P. ; Harazim, H. ; Smekalova, O. ; Kosinova, M. ; Kolacek, T. ; Hudacek, K. ; Drab, M. ; Brujevic, J. ; Vitkova, K. ; Jirmanova, K. ; Volfova, I. ; Dzurnakova, P. ; Liskova, K. ; Dudas, R. ; Filipsky, R. ; El Kafrawy, S. ; Hosny Abdelwahab, H. ; Metwally, T. ; Abdel-Razek, A. ; El-Shaarawy, A. M. ; Fathy Hasan, W. ; Gouda Ahmed, A. ; Yassin, H. ; Magdy, M. ; Abdelhady, M. ; Mahran, M. ; Herodes, E. ; Kivik, P. ; Oganjan, J. ; Aun, A. ; Sormus, A. ; Sarapuu, K. ; Mall, M. ; Karjagin, J. ; Futier, E. ; Petit, A. ; Gerard, A. ; Marret, E. ; Solier, M. ; Prades, A. ; Krassler, J. ; Merzky, S. ; Uhlig, C. ; Kiss, T. ; Bundy, A. ; Bluth, T. ; Güldner, A. ; Spieth, P. ; Scharffenberg, M. ; Tran Thiem, D. ; Koch, T. ; Treschan, T. ; Schaefer, M. ; Bastin, B. ; Geib, J. ; Weiss, M. ; Kienbaum, P. ; Pannen, B. ; Gottschalk, A. ; Konrad, M. ; Westerheide, D. ; Schwerdtfeger, B. ; Simon, P. ; Reske, A. ; Nestler, C. ; Valsamidis, D. ; Stroumpoulis, K. ; Antholopoulos, G. ; Andreou, A. ; Karapanos, D. ; Theodoraki, K. ; Gkiokas, G. ; Tasoulis, M. K. ; Sidiropoulou, T. ; Zafeiropoulou, F. ; Florou, P. ; Pandazi, A. ; Tsaousi, G. ; Nouris, C. ; Pourzitaki, C. ; Bystritski, D. ; Pizov, R. ; Eden, A. ; Pesce, C. V. ; Campanile, A. ; Marrella, A. ; Grasso, S. ; De Michele, M. ; Bona, F. ; Giacoletto, G. ; Sardo, E. ; Giancarlo, L. ; Sottosanti, V. ; Solca, M. ; Volta, C. A. ; Spadaro, S. ; Verri, M. ; Ragazzi, R. ; Zoppellari, R. ; Cinnella, G. ; Raimondo, P. ; La Bella, D. ; Mirabella, L. ; D'antini, D. ; Molin, A. ; Brunetti, I. ; Gratarola, A. ; Pellerano, G. ; Sileo, R. ; Pezzatto, S. ; Montagnani, L. ; Pasin, L. ; Landoni, G. ; Zangrillo, A. ; Beretta, L. ; Di Parma, A. L. ; Tarzia, V. ; Dossi, R. ; Sassone, M. E. ; Sances, D. ; Tredici, S. ; Spano, G. ; Castellani, G. ; Delunas, L. ; Peradze, S. ; Venturino, M. ; Arpino, I. ; Sher, S. ; Tommasino, C. ; Rapido, F. ; Morelli, P. ; Vargas, M. ; Servillo, G. ; Cortegiani, A. ; Raineri, S. 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L. ; Cadilha, S. ; Appleton, S. ; Parente, S. ; PAULINO GOMES CORREIA, MARIA DULCE ; Martins, D. ; Monteirosa, A. ; GARCIA DE CASTRO INSUA, RICARDO ANTONIO ; Rodrigues, S. ; Horhota, L. ; Grintescu, I. M. ; Mirea, L. ; Grintescu, I. C. ; Corneci, D. ; Negoita, S. ; Dutu, M. ; Popescu Garotescu, I. ; Filipescu, D. ; Prodan, A. B. ; Droc, G. ; Fota, R. ; Popescu, M. ; Tomescu, D. ; Petcu, A. M. ; Tudoroiu, M. I. ; Moise, A. ; Guran, C. T. ; Gherghina, I. ; Costea, D. ; Cindea, I. ; Copotoiu, S. M. ; Copotoiu, R. ; Barsan, V. ; Tolcser, Z. ; Riciu, M. ; Moldovan, G. S. ; Veres, M. ; Gritsan, A. ; Kapkan, T. ; Gritsan, G. ; Korolkov, O. ; Kulikov, A. ; Lubnin, A. ; Ovezov, A. ; Prokoshev, P. ; Lugovoy, A. ; Anipchenko, N. ; Babayants, A. ; Komissarova, I. ; Zalina, K. ; Likhvantsev, V. ; Fedorov, S. ; Lazukic, A. ; Pejakovic, J. ; Mihajlovic, D. ; Kusnierikova, Z. ; Zelinkova, M. ; Bruncakova, K. ; Polakovicova, L. ; Sobona, V. ; Novak-Supe, B. ; Pekle-Golez, A. ; Jovanov, M. ; Strazisar, B. ; Markovic-Bozic, J. ; Novak-Jankovic, V. ; Voje, M. ; Grynyuk, A. ; Kostadinov, I. ; Spindler-Vesel, A. ; Moral, V. ; Unzueta, C. ; Puigbo, C. ; Fava, J. ; Moret, E. ; Rodriguez Nunez, M. N. ; Sendra, M. ; Brunelli, A. ; Rodenas, F. ; Monedero, P. ; Hidalgo Martinez, F. ; Yepes Temino, M. J. ; Marti Nez Simon, A. ; de Abajo Larriba, A. ; Lisi, A. ; Perez, G. ; Martinez, R. ; Granell, M. ; Tatay Vivo, J. ; Saiz Ruiz, C. ; de Andre S Iban Ez, J. A. ; Pastor, E. ; Soro, M. ; Ferrando, C. ; Defez, M. ; Aldecoa Alvares-Santullano, C. ; Pere, R. ; Rico, J. ; Jawad, M. ; Saeed, Y. ; Gillberg, L. ; Kazak Bengisun, Z. ; Kansu Kazbek, B. ; Coskunfirat, N. ; Boztug, N. ; Sanli, S. ; Yilmaz, M. ; Hadimioglu, N. ; Senturk, N. M. ; Camci, E. ; Kucukgoncu, S. ; Sungur, Z. ; Sivrikoz, N. ; Ustalar Ozgen, S. ; Toraman, F. ; Selvi, O. ; Senturk, O. ; Yildiz, M. ; Kuvaki, B. ; Gunenc, F. ; Kucukguclu, S. ; Ozbilgin, S. U. ; Maral, J. ; Canli, S. ; Arun, O. ; Saltali, A. ; Aydogan, E. ; Akgün, F. N. ; Sanlikarip, C. ; Mine Karaman, F. ; Mazur, A. ; Vorotyntsev, S. ; Rousseau, G. ; Barrett, C. ; Stancombe, L. ; Shelley, B. ; Scholes, H. ; Limb, J. ; Rafi, A. ; Wayman, L. ; Deane, J. ; Rogerson, D. ; Williams, J. ; Yates, S. ; Rogers, E. ; Pulletz, M. ; Moreton, S. ; Jones, S. ; Venkatesh, S. ; Burton, M. ; Brown, L. ; Goodall, C. ; Rucklidge, M. ; Fuller, D. ; Nadolski, M. ; Kusre, S. ; Lundberg, M. ; Everett, L. ; Nutt, H. ; Zuleika, M. ; Carvalho, P. ; Clements, D. ; Creagh-Brown, B. ; Watt, P. ; Raymode, P. ; Mohr, O. ; Raj, A. ; Creary, T. ; Chishti, A. ; Bell, A. ; Higham, C. ; Cain, A. ; Gibb, S. ; Mowat, S. ; Franklin, D. ; West, C. ; Minto, G. ; Boyd, N. ; Calton, E. ; Walker, R. ; Mackenzie, F. ; Ellison, B. ; Roberts, H. ; Chikungwa, M. ; Jackson, C. ; Donovan, A. ; Foot, J. ; Homan, E. ; Montgomery, J. ; Portch, D. ; Mercer, P. ; Palmer, J. ; Paddle, J. ; Fouracres, A. ; Datson, A. ; Andrew, A. ; Welch, L. ; Rose, A. ; Varma, S. ; Simeson, K. ; Rambhatla, M. ; Susarla, J. ; Marri, S. ; Kodaganallur, K. ; Das, A. ; Algarsamy, S. ; Colley, J. ; Davies, S. ; Szewczyk, M. ; Smith, T. ; Fernandez-Bustamante, A. ; Luzier, E. ; Almagro, A. ; Fernando, L. ; Sulemanji, D. ; Sprung, J. ; Weingarten, T. ; Kor, D. ; Scavonetto, F. ; Tze, Y. ; Bogdanovic Dvor cak, M. |
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| Zeitschrift: | EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 2017, S. 492-507 |
| Veröffentlichung: | Lippincott Williams and Wilkins, 2017 |
| Medientyp: | academicJournal |
| DOI: | 10.1097/EJA.0000000000000646 |
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