Cardiothoracic & vascular anesthesia
Association between driving pressure and postoperative pulmonary complications in patients undergoing lung resection surgery: A randomised clinical trial
Primary resultResult — go to the resultRelative risk 0.32 95% CI 0.10–0.90Authors' conclusion
Among patients undergoing selective lung surgery, intraoperative OLV with PEEP titration to the lowest driving pressure compared with conventional low PEEP level (4 cm H2O) significantly reduced PPCs within the first 3 postoperative days, however, did not significantly reduce PPCs within the first 7 postoperative days.
Study context
- Population
- Patients undergoing selective lung resection surgery with one-lung ventilation (OLV), volume-controlled ventilation, tidal volume 6 mL/kg predicted body weight207 completed
- Participants
- 222 patients
- Comparison
- Positive end-expiratory pressure (PEEP) titrated to lowest driving pressure vs conventional low PEEP (4 cm H2O) during OLV
- PEEP titration to the lowest driving pressuren = 104
- Conventional low level of PEEPn = 103reference
- Primary endpoint
- PPCs: 4 or more of eight Melbourne Group Scale (MGS) variables
- Follow-up
- First 3 days after surgery
Methodological detailssingle-centre
- Single-centre
Primary result
As reported in the abstract
Relative risk
0.32
95% CI 0.10–0.90
P = 0.021
Events by treatment group
PEEP titration to the lowest driving pressure vs Conventional low level of PEEP
RR 0.32 (95% CI 0.10–0.90); P = 0.021
Further findings
Postoperative pulmonary complications (PPCs) within first 7 postoperative days
- Not significantly reduced
Original publication
Association between driving pressure and postoperative pulmonary complications in patients undergoing lung resection surgery: A randomised clinical trial. Anaesth Crit Care Pain Med. Published 19 September 2022. doi:10.
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