Cardiothoracic & vascular anaesthesia
Ventilatory Mechanics, Oxygenation and Postoperative pulmonary complications according to surgical approach in patients with Individualised Ventilatory Approach. A secondary analysis of the iPROVE-OLV trial
Authors' conclusion
Among patients undergoing lung resection procedures in whom an iOLA approach was performed, ventilatory mechanics and oxygenation were comparable between VATS and thoracotomy, with no significant differences in severe PPCs during the first 7 and 30 postoperative days.
Study context
- Population
- Patients undergoing lung resection with OLV under an individualised perioperative open-lung approach (individualized OLA (iOLA): protective ventilation, recruitment maneuvers with individualised positive end-expiratory pressure (PEEP), postoperative HFNO)iOLA group of 1.380 trial patients
- Participants
- 645 patients
- Comparison
- Video-assisted thoracoscopy surgery (VATS) vs thoracotomy within the iOLA ventilation strategy
- VATSn = 458
- Thoracotomyn = 187reference
- Primary endpoint
- Driving pressure, PEEP, compliance and oxygenation during OLV (T2)
- Follow-up
- During OLV (T2)
Methodological detailsinternational, multicentre
- International
- Multicentre
Primary result
As reported in the abstract
- VATS
- PEEP, mean ± SD 5.07 ± 1.73 vs. 5.19 ± 1.67 cmH2O; P = 0.461
- VATS
- Plateau pressure, mean ± SD 18.59±4.53 vs. 18.87 ± 5.04 cmH2O; P = 0.539
- VATS
- Driving pressure, mean ± SD 13.50±4.68 vs. 13.67 ± 5.16; P = 0.725
- VATS
- Dynamic compliance, mean ± SD 34.70±14.19 vs. 34.37 ± 12.29 ml/cmH2O; P = 0.802
- VATS
- PaO2/FiO2 ratio, mean ± SD 185.47 ± 91.75 vs. 197.64 ± 102.61 mmHg; P = 0.160
Secondary outcomes
| Outcome | VATS | Thoracotomy | RR (95% CI) | P value | |
|---|---|---|---|---|---|
| Severe PPCs · first 7 postoperative days | 5.24% | 8.02% | 1.53 (0.82–2.85) | P = 0.20 | |
| Severe PPCs · first 30 postoperative days | 6.55% | 9.09% | 1.38 (0.78–2.45) | P = 0.315 | |
| 0.20.5125Relative risk (log scale) |
Original publication
Ventilatory Mechanics, Oxygenation and Postoperative pulmonary complications according to surgical approach in patients with Individualised Ventilatory Approach. A secondary analysis of the iPROVE-OLV trial. Anaesth Crit Care Pain Med. Published 22 September 2026. doi:10.
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