Cardiothoracic & vascular anesthesia
Efficacy of maintaining low-tidal volume mechanical ventilation as compared to resting lung strategy during coronary artery bypass graft cardiopulmonary bypass surgery: A post-hoc analysis of the MECANO trial
Primary resultResult — go to the resultOdds ratio 0.56 CI 0.37–0.84Authors' conclusion
In this post-hoc analysis, maintaining low-tidal ventilation compared to a resting-lung strategy was associated with fewer pulmonary postoperative complications in patients who underwent isolated CABG procedures.
Study context
- Population
- Patients undergoing isolated on-pump CABG surgery, tertiary care cardiac surgery centerfrom 1501 in original trial
- Participants
- 725 patients
- Comparison
- Low-tidal-volume ventilation with PEEP vs no ventilation during CPB
- VENTn = 352
- No-ventilation (noV)n = 373reference
- Primary endpoint
- Composite of:
- Death
- Early respiratory failure
- Ventilation support beyond day 2
- Reintubation
Methodological detailspost-hoc analysis, single-centre, blind, parallel-group
- Post-hoc analysis
- Single-centre
- Blind
- Parallel-group
Primary result
As reported in the abstract
Odds ratio
0.56
CI 0.37–0.84
P = 0.004
Events by treatment group
VENT vs noV
OR 0.56 (CI 0.37–0.84); P = 0.004
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Early respiratory dysfunction | 0.34 (0.12–0.96) | P = 0.033 | |
| Prolonged respiratory support | 0.51 (0.27–0.94) | P = 0.029 | |
| 0.10.31310Odds ratio (log scale) |
Safety
Complications related to mechanical ventilation
- Similar in the two groups
Original publication
Efficacy of maintaining low-tidal volume mechanical ventilation as compared to resting lung strategy during coronary artery bypass graft cardiopulmonary bypass surgery: A post-hoc analysis of the MECANO trial. J Clin Anesth. Published 5 November 2022. doi:10.
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