Cardiothoracic & vascular anaesthesia
Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial
Authors' conclusion
Among patients subjected to lung resection under one-lung ventilation, iOLA was associated with a reduced risk of severe postoperative pulmonary complications when compared with conventional lung-protective ventilation.
Study context
- Population
- Adults (≥18 years) scheduled for open or video-assisted thoracic surgery with OLV in 25 hospitals in Spain, Italy, Turkey, Egypt, and Ecuador1,308 analysed
- Participants
- 1,380 adults
- Comparison
- Individualised OLA (iOLA) vs Standard lung-protective ventilation
- iOLAn = 670
- Standard lung-protective ventilationn = 638reference
- Primary endpoint
- Composite of severe PPCs (atelectasis requiring bronchoscopy, severe respiratory failure, contralateral pneumothorax, early extubation failure, ARDS, pulmonary infection, bronchopleural fistula, pleural empyema)
- Follow-up
- First 7 postoperative days
Methodological detailsmulticentre, Operating and postoperative room data not blinded; data at 24 h acquired by an investigator blinded to group allocation
- Multicentre
- Operating and postoperative room data not blinded; data at 24 h acquired by an investigator blinded to group allocation
Primary result
As reported in the abstract
Each group vs standard lung-protective ventilationRelative risk (95% CI)
iOLA
0.39(0.28–0.56)
Each group vs standard lung-protective ventilationAbsolute risk difference (95% CI)
iOLA
−9.23(−12.55 to −5.92)
Safety
- Recruitment manoeuvre-related adverse events
- 5
Original publication
Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial. Lancet Respir Med. Published 5 December 2023. doi:10.
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