Respiratory failure & ventilation
Effect of inspiratory oxygen fraction during driving pressure-guided ventilation strategy on pulmonary complications following open abdominal surgery: A randomized controlled trial
Primary result · PPCsResult — go to the resultRelative risk 0.72 95 % CI 0.61–0.84Authors' conclusion
In patients undergoing open abdominal surgery, using a 30 % FIO2, compared with 80 % FIO2, in context of driving pressure-guided ventilation strategy, intraoperatively reduced the incidence and severity of pulmonary complications within the first 7 postoperative days.
Study context
- Population
- Adults, ASA I–III, scheduled for major open abdominal surgery under GA, tertiary university hospital in ChinaITT analysis
- Participants
- 514 adults
- Comparison
- 30% vs 80% FiO2 during driving pressure-guided ventilation
- Primary endpoint
- Composite of pulmonary complications
- Follow-up
- Within 7 days postoperatively
Methodological detailssingle-centre, prospective
- Single-centre
- Prospective
Primary result
PPCs
Relative risk
0.72
95 % CI 0.61–0.84
P < 0.001
By group
30 % FIO2 vs 80 % FIO2
RR 0.72 (95 % CI 0.61–0.84); P < 0.001
As reported in the abstract
Secondary outcomes
| Outcome | 30 % FIO2 | 80 % FIO2 | P value |
|---|---|---|---|
| Severity score of PPCs · within 7 postoperative days | P < 0.001 | ||
| Dynamic compliance · end of surgery | 56 (IQR 48–66) | 53 (IQR 46–62) | P = 0.027 |
Severity score of postoperative pulmonary complications (PPCs) · within 7 postoperative days
- Significantly reduced in the 30 % fraction of inspired oxygen (FIO2) group
Safety
%
| Outcome | 30 % FIO2 | 80 % FIO2 | RR (95 % CI) | P value | |
|---|---|---|---|---|---|
| Oxygen desaturation (SpO2 < 94 %) on air in PACU · PACU stay | 18.5 | 30.4 | 0.61 (0.44–0.84) | P = 0.002 | |
| 0.512Relative risk (log scale) |
Original publication
Effect of inspiratory oxygen fraction during driving pressure-guided ventilation strategy on pulmonary complications following open abdominal surgery: A randomized controlled trial. J Clin Anesth. Published 6 November 2024. doi:10.
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