Cardiothoracic & vascular anesthesia
Driving pressure-guided ventilation and postoperative pulmonary complications in thoracic surgery: a multicentre randomised clinical trial
Primary resultResult — go to the resultRisk difference −2.3% 95% CI −8.0% to 3.3%Authors' conclusion
In lung resection surgery, a driving pressure-guided ventilation improved pulmonary mechanics intraoperatively, but did not reduce the incidence of postoperative pulmonary complications compared with a conventional protective ventilation.
Study context
- Population
- Patients undergoing lung resection surgery1,170 in modified ITT analysis
- Participants
- 650 vs 650
- Comparison
- Driving pressure vs Protective ventilation
- Driving pressuren = 650
- Protective ventilationn = 650reference
- Primary endpoint
- Composite of pulmonary complications
- Follow-up
- Within 7 days postoperatively
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
Risk difference
−2.3%
95% CI −8.0% to 3.3%
P = 0.42
Events by treatment group
Driving pressure vs Protective ventilation
risk difference −2.3% (95% CI −8.0% to 3.3%); P = 0.42
Further findings
Mean, cm H2O
| Outcome | Driving pressure | Protective ventilation | Mean difference (cm H2O) (95% CI) | P value | |
|---|---|---|---|---|---|
| Driving pressure | 7.1 | 9.2 | −2.1 (−2.4 to −1.9) | P < 0.001 | |
| −3−2−101Difference, cm H2O (linear scale) |
Lung compliance · intraoperatively
P < 0.001
PaO2 · intraoperatively
P = 0.03
Need for rescue ventilation · intraoperatively
P = 0.02
Original publication
Driving pressure-guided ventilation and postoperative pulmonary complications in thoracic surgery: a multicentre randomised clinical trial. Br J Anaesth. Published 20 August 2022. doi:10.
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