e-Article
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
Document Type
article
Author
Guido Mazzinari; Ary Serpa Neto; Sabrine N. T. Hemmes; Goran Hedenstierna; Samir Jaber; Michael Hiesmayr; Markus W. Hollmann; Gary H. Mills; Marcos F. Vidal Melo; Rupert M. Pearse; Christian Putensen; Werner Schmid; Paolo Severgnini; Hermann Wrigge; Oscar Diaz Cambronero; Lorenzo Ball; Marcelo Gama de Abreu; Paolo Pelosi; Marcus J. Schultz; for the LAS VEGAS study–investigators; the PROtective VEntilation NETwork; the Clinical Trial Network of the European Society of Anaesthesiology
Source
BMC Anesthesiology, Vol 21, Iss 1, Pp 1-15 (2021)
Subject
Language
English
ISSN
1471-2253
Abstract
Abstract Background It is uncertain whether the association of the intraoperative driving pressure (ΔP) 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 ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW 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%. ΔP was lower in open abdominal surgery patients, but ΔPTW was not different between groups. The association of ΔPTW 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