Perioperative medicine & outcomes
Intraoperative Mechanical Power and Postoperative Pulmonary Complications in Noncardiothoracic Elective Surgery Patients: A 10-Year Retrospective Cohort Study
Authors' conclusion
In the study's population, decreased rather than increased tidal volume, decreased compliance, increased mechanical power, and decreased end-tidal carbon dioxide were independently associated with postoperative pulmonary complications.
Study context
- Population
- Adults undergoing noncardiac, nonthoracic elective surgery under GA with tracheal intubation, Lille University Hospital, France, 2010–2019
- Participants
- 33,701 adults
- Exposure
- Intraoperative ventilation parameters in patients with vs without PPCs
- PPCsn = 2,033
- Outcome
- PPCs (respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm, aspiration pneumonitis)
- Follow-up
- Within 7 days of surgery
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Intraoperative ventilation parameters independently associated with PPCs
Estimate (95% CI)P value
Lower tidal volume to predicted body weight ratio
OR per −1 ml·kgPBW-1 1.08(1.02–1.14)
P < 0.001Higher mechanical power
OR per 4 J·min-1 1.37(1.26–1.49)
P < 0.001Oxygen saturation measured by pulse oximetry less than 96%
OR 2.42(1.97–2.96)
P < 0.001Lower end-tidal carbon dioxide
OR per −3 mmHg 1.06(1.00–1.13)
P = 0.023- Dynamic respiratory system compliance less than 30 ml·cm H2O
- 1.30 (95% CI 1.15–1.46); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Subhazard ratio (95% CI) | P value | |
|---|---|---|---|
| Hospital LOS (longer with PPCs) | 0.43 (0.40–0.45) | ||
| In-hospital mortality | 6.0 (4.1–9.0) | P < 0.001 | |
| 1-yr mortality | 2.65 (2.33–3.02) | P < 0.001 | |
| 0.10.31310Subhazard ratio (log scale) |
| Outcome | OR (95% CI) | P value |
|---|---|---|
| ICU admission | 12.5 (6.6–10.1) | P < 0.001 |
Original publication
Intraoperative Mechanical Power and Postoperative Pulmonary Complications in Noncardiothoracic Elective Surgery Patients: A 10-Year Retrospective Cohort Study. Anesthesiology. Published 27 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →