Cardiothoracic & vascular anesthesia
Maintaining ventilation with very low tidal volume and positive-end expiratory pressure versus no ventilation during cardiopulmonary bypass for cardiac surgery in adults: a randomized clinical trial
Primary resultResult — go to the resultRelative risk 0.92 95% CI 0.67–1.25Authors' conclusion
Maintaining very low tidal volume ventilation with positive end-expiratory pressure during CPB did not reduce postoperative infections at 28 days compared to when mechanical ventilation was stopped during CPB.
Study context
- Population
- Adults undergoing scheduled cardiac surgery with cardiopulmonary bypass (CPB) in six hospitals in France
- Participants
- 1,362 adults
- Comparison
- Ventilation maintained during CPB vs ventilation stopped during CPB
- Mechanical ventilation (MV)-n = 680reference
- MV +n = 682
- Primary endpoint
- Occurrence of all types of postoperative infections
- Follow-up
- Within the first 28 days after surgery
Methodological detailsmulticentre, single-blind
- Multicentre
- Single-blind
Primary result
As reported in the abstract
Relative risk
0.92
95% CI 0.67–1.25
P = 0.58
Events by treatment group
MV + vs MV-
RR 0.92 (95% CI 0.67–1.25); P = 0.58
Secondary outcomes
| Outcome | IRR (95% CI) | P value | |
|---|---|---|---|
| Antibiotic use (days of exposure)Higher in the MV + group | 1.08 (1.02–1.15) | P = 0.02 | |
| 0.512Incidence rate ratio (log scale) |
All other secondary outcomes
- No significant differences between the groups
Safety
Adverse events
- No significant difference between the groups in incidence
Original publication
Maintaining ventilation with very low tidal volume and positive-end expiratory pressure versus no ventilation during cardiopulmonary bypass for cardiac surgery in adults: a randomized clinical trial. Intensive Care Med. Published 5 May 2025. doi:10.
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