4 research outputs found
Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study
- Author
- Abad Gurumeta A.
- Abernethy C.
- Abigail P.
- Achaibar K.
- Adam E.
- Afshari A.
- Agudelo Montoya M. E.
- Akgun F. N.
- Aletti G.
- Alkis N.
- Allan A.
- Allan K.
- Allaouchiche B.
- Allcock C.
- Almasy E.
- Amey I.
- Amigoni M.
- Andersen E.
- Andersson P.
- Anipchenko N.
- Antunes P.
- Armstrong E.
- Aslam T. N.
- Aslin B.
- Assuncao J. P.
- Ausserer J.
- Avvai M.
- Awad N.
- Ayas Montero B.
- Ayuso M.
- Azevedo P.
- Badarau V.
- Badescu R.
- Baiardo Redaelli M.
- Baird C.
- Baird Y.
- Baker T.
- Balaji P.
- Balan C.
- Balandin A.
- Balescu-Arion C.
- Baliuliene V.
- Baltasar Isabel J.
- Baluch S. N.
- Bandrabur D.
- Bankewitz C.
- Barber K.
- Barbera F.
- Barcraft-Barnes H.
- Barletti V.
- Barnett G.
- Baron K.
- Barros A.
- Barsan V.
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- Batistaki C.
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology
Mortality after surgery in Europe: a 7 day cohort study
- Author
- Aakeroey K
- Acan I
- Adams D
- Adams T
- Adanic M
- Adolfsson A
- Afonso O
- Afshari A
- Agarwal B
- Agnic I
- Aguado DN
- Ahern R
- Ahonen T
- Aignatoaie M
- Akotia N
- Akouds E
- Al Abdaly A
- Al Subaie N
- Alagarsamy F
- Alameda LE
- Alaspää A
- Albalad DD
- Albaladejo P
- Albante A
- Alberdi F
- Albu C
- Alcaide CM
- Alcantud JF
- Aldecoa C
- Aldecoa C
- Alderson L
- Aleixandre IS
- Aleksic D
- Aleman M
- Alexander D
- Alexander P
- Algarra RR
- Ali ZS
- Aliste P
- Allué RM
- Almeida E
- Almeida IM
- Almeras L
- Alonso AE
- Alonso E
- Alvarez AA
- Alvarez LR
- Amaniti E
- Amatya S
- Ampuero MS
- Anchuelo AH
- Andabaka T
- Andersen JD
- Anderson H
- Andresen B
- Angulo GO
- Anna US
- Anthopoulos G
- Antolinos MA
- Apsokardos A
- Aracil N
- Aranzubia M
- Arawwawala D
- Arcas JJ
- Arevalo J
- Argente GR
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- Arpino I
- Arroyo MM
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- Artigas X
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- Arviza LP
- Asensio MA
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- Ayman M
- Baban O
- Bacak Kocman I
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- Bailey K
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- Balenovic I
- Ball C
- Ballington R
- Balust C
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- Bandic D
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- Barižon M
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- Barr K
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- Bartolomé MJ
- Bataillard A
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- Bates D
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- Battistella M
- Bauer P
- Bauer W
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- Baumgarten R
- Baxter I
- Bazin M
- Beach M
- Becanne X
- Beck O
- Beckingsale A
- Bekos V
- Belavic M
- Belcher A
- Belciu I
- Belenguer Muncharaz A
- Belhaj A
- Belikova B
- Bellotti F
- Belvert BQ
- Benayoun L
- Bento HC
- Bento L
- Bergamini E
- Berger K
- Berger P
- Bergin A
- Bermejo FJ
- Bernal DG
- Bernat Álvarez MJ
- Berneanu M
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- Bestle M
- Betancor NO
- Bettelli G
- Bewley J
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- Bianchin A
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- Bingold F
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- Black E
- Blaj M
- Blanco IA
- Bland M
- Blauwen Nd
- Blažanin B
- Blichfeldt L
- Bloos F
- Blunt M
- Blöndal Á
- Bobinac M
- Bodega BM
- Boerma C
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- Bogdan P
- Boksasp OD
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- Boninsegna D
- Bonnet A
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- Bonnländer G
- Borchers F
- Bordeianu C
- Borja MM
- Borovsak Z
- Borrat X
- Bosinceanu D
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- Bozovic MD
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- Božic A
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- Bratanic M
- Brattström O
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- Brozovic G
- Bruce J
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- Brunori E
- Bráz K
- Brünner H
- Bucci B
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- Buhre W
- Bulasevic A
- Bullock L
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- Buttera S
- Bártolo A
- Béclère A
- Caballero J
- Cabanes S
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- Calderón R
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- Calton E
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- Canalechevarria AM
- Candi GM
- Cantarini E
- Capel YJ
- Capková J
- Capone M
- Capuzzo M
- Carballal FF
- Carballo CL
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- Cartlidge D
- Carvalho A
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- Castiñeiras AP
- Castrillón S
- Castro Mde L
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- Castro NM
- Catalán M
- Cecconi M
- Centonze C
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- Cerny V
- Cerutti E
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- Ciobanu A
- Cirillo V
- Ciubotaru R
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- Clausen NG
- Clauwaert C
- Claxton A
- Clouva Molyvdas PM
- Cocu S
- Codreanu M
- Collantes E
- Collard E
- Collareta M
- Collates AF
- Collin V
- Collins D
- Collins H
- Collyer T
- Concostrina Mde L
- Conway D
- Copley E
- Copotoiu R
- Copotoiu SM
- Coppini R
- Corneci D
- Corner V
- Corradetti F
- Correia C
- Corsini LM
- Cortes JG
- Cortés AF
- Costagliola R
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- Craker L
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- Cremades M
- Crespo BI
- Crespo Mdel R
- Crespo P
- Cristina MV
- Crooks N
- Crowley S
- Csomos A
- Csüllög E
- Cuarental A
- Cubillos DN
- Cupitt J
- Currie V
- Cvachovec K
- Czeslick E
- Cíková A
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- Damian M
- Damjanovska M
- Damster S
- Danira V
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- Day C
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- de Almeida J
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- de la Lastra M
- de la Torre PA
- de Maeyer AG
- de Meneses H
- De Michele M
- De Neve N
- de Prat IC
- de Quevedo SA
- de Rabago RB
- De Rudnicki S
- De Simone M
- de Sousa AC
- de Sousa M
- De Wit E
- de Zayas RS
- Debelic D
- Debernardi F
- Del Olmo M
- Delgado FC
- Delgado HG
- Delgado TR
- Delic N
- Dell'unto S
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- Della Rocca G
- Della Rocca G
- Demars N
- Dempsey G
- Denciu CI
- Dennesen P
- Derumeaux P
- Desbordes J
- Desikan S
- Deutsch PA
- Di Mauro P
- Di Noto A
- Diaconescu C
- Diaz A
- Diaz Boladeras RM
- Diaz DS
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- Dimitropoulos K
- Dinescu SA
- Dinu M
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- Djordjevic D
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- Dokka V
- Domínguez D
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- Doyle Y
- Drab M
- Dragoumanis C
- Dragulescu D
- Dražen B
- Drenjancevic IH
- Drescher J
- Dresden C
- Dropulic N
- Druwé P
- Dubois Vallaud D
- Dufur M
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- Dumenil AS
- Dunne K
- Duque P
- Durán MV
- Duzel V
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- Díez EP
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- Elisei D
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- Ellermaa J
- ElMiloudi F
- Elomaa E
- Elson MZ
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- Elósegui I
- Engelen WC
- Epure F
- Ercole A
- Erkens U
- Erler I
- Ernst S
- Espinosa E
- Espinosa N
- Esteruelas JA
- Esteva GE
- Esteves F
- Estilita J
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- Farnia A
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- Fernández LF
- Fernández PT
- Fernández SR
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- Fuster ML
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- Galambos Z
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- Gandolfi A
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- García PD
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- García Sanz M
- García V
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- Gardin C
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- Gatta A
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- Gazibegovic N
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2012
- Field of study
Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p<0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology
Mortality after surgery in Europe: a 7 day cohort study.
- Author
- \u160akic K
- \u160aric JP
- \u160eric J
- \u160imic-Korac N
- \u160imurina T
- \u160ribar A
- \u17dilic A
- \u17dilinc\ue1rov\ue1 V
- \u17duni J
- \u17dupcic M
- \uc1lvaro JL
- \uc5lvarez JT
- \ucd\uf1igo JA
- Aakeroey K
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- Alameda LE
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- Aleixandre IS
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- Algarra RR
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- Publication venue
- Publication date
- 01/01/2012
- Field of study
Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study
- Author
- A. M. Leonardi
- A. M. Varsani
- A. W. M. M. Kopp
- A. Abernethy
- A. Allaouchiche
- A. Balescu-Arion
- A. Barsan
- A. Beretta
- A. Bilskiene
- A. Bowen
- A. Bucolo
- A. Calhau
- A. Cammu
- A. Carise
- A. Casal
- A. Chinery
- A. Chondhury
- A. Costa
- A. Cox
- A. Curley
- A. Danninger
- A. Dinic
- A. f Hollmann
- A. Ferrando
- A. Filipescu
- A. Floris
- A. Georghiou
- A. Gibson
- A. Gievski
- A. Giovannoni
- A. Granell
- A. Grassetto
- A. Greenwood
- A. Grigoras
- A. Gritsan
- A. Guadagnin
- A. Hagau
- A. Hribar
- A. Humphreys
- A. Hussein
- A. Hyams
- A. Kumar
- A. Landoni
- A. Lišková
- A. Loganathan
- A. Luippold
- A. Macas
- A. Macgregor
- A. Margalef
- A. Melia
- A. Melotti
- A. Minto
- A. Moise
- A. Mokini
- A. Moltó
- A. Moura
- A. Negri
- A. Nicholas
- A. Novillo
- A. Oliveira
- A. Ovezov
- A. Ozbilgin
- A. Papapostolou
- A. Pasin
- A. Paunescu
- A. Petta
- A. Rato
- A. Razaque
- A. Schiavone
- A. Soro
- A. Spadaro
- A. Spindler-Vesel
- A. Stamelos
- A. Standl
- A. Sultanpori
- A. Toretti
- A. Tudor
- A. Turan
- A. Vissicchio
- A. Voje
- A. Vrecic-Slabe
- A. Wallberg
- A. Weller
- A. Zani
- A. Zieglerder
- Abad Gurumeta
- Agudelo Montoya
- Ayas Montero
- B. C. Meier
- B. V. Mushambi
- B. Allcock
- B. Assunção
- B. Ayuso
- B. Charnock
- B. Debreceni
- B. Franke
- B. Gferer
- B. Harvey
- B. Hestenes
- B. Iannuccelli
- B. Jankovic
- B. Joachim
- B. Junke
- B. Kadaoui
- B. Kuzmanovska
- B. Kyttari
- B. Levstek
- B. Malewski
- B. Marcu
- B. Mccourt
- B. Stourac
- B. Tsaousi
- B. Verheyen
- B. Vizcaychipi
- B. Wilson
- Baiardo Redaelli
- Baltasar Isabel
- Becerra Cayetano
- Belmonte Cuenca
- Bermudez Lopez
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- C. Abigail
- C. Almasy
- C. Baird
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- H. Rial
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- H. Tiganiuc
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- H. Wikström
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- Herrera Hueso
- I. A. Bell
- I. Amigoni
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- J. Stefan
- J. Szederjesi
- J. Taddei
- J. Toninelli
- J. Ursic
- J. Wallner
- Jiménez Gomez
- Jonsson Fagerlund
- K. Adam
- K. Allan
- K. b Blobner
- K. Barbera
- K. Barros
- K. Blincoe
- K. Borys
- K. Czuczwar
- K. Davies
- K. Hermanides
- K. Hoelbling
- K. Ilyas
- K. Korfiotis
- K. Legett
- K. Mascarenhas
- K. Mcgill
- K. Mukhtar
- K. Muniyappa
- K. Novak-Jankovic
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- K. Struck
- K. Thornley
- Kanski A.
- Karadag S.
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- Kasnik D.
- Katanolli F.
- Katsika E.
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- Kooij F.
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- Koopman - van Gemert
- L. G. Vico
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- L. Bouwman
- L. Bowrey
- L. Božić
- L. Brazzoni
- L. Cindea
- L. Desai
- L. Ferreira
- L. Foerster
- L. Gilowska
- L. Hayes
- L. Hemmes
- L. Hormis
- L. Jovic
- L. Kunit
- L. Lowicka
- L. Markic
- L. Mirea
- L. Mittelstädt
- L. Moeglen
- L. Monea
- L. Männer
- L. Oldner
- L. Palugniok
- L. Passey
- L. Pitterle
- L. Pompei
- L. Popescu
- L. Rimaitis
- L. Scanlon
- L. Stanculescu
- L. Syrogianni
- L. Telford
- L. Toim
- L. Vercauteren
- L. Watson
- L. Wright
- L. Zucker
- Lewald H. A
- Lluch Oltra
- Lopez Rodríguez
- M. C. Montalto
- M. C. Sörmus
- M. E. Akgün
- M. I. Reavley
- M. I. Valsamidis
- M. L. Garg
- M. P. Voicu
- M. R. Mercer
- M. -A.
- M. -T.
- M. aEmail Author
- M. Andersen
- M. Awad
- M. Azevedo
- M. Baird
- M. Belletti
- M. Bergmann
- M. Bernotaite
- M. Beurskens
- M. Borstnar
- M. Boselli
- M. Brear
- M. c Hoeft
- M. Can
- M. Cantor
- M. Casanova
- M. Casero
- M. Cocu
- M. Cuomo
- M. Dabrowska
- M. Daniliuc
- M. g Meistelman
- M. Gallacher
- M. Gerjevic
- M. Goranovic
- M. Granstrom
- M. Gunenc
- M. Güçlü
- M. Hawkins
- M. Jimenez
- M. Jungwirth
- M. Kotzinger
- M. Kranke
- M. Köstenberger
- M. Lercher
- M. Leva
- M. Limb
- M. Lorenzini
- M. Lugovoy
- M. Lumb
- M. Machado
- M. Madeira
- M. Marinheiro
- M. Martinez
- M. Michlig
- M. Milojevic
- M. Miñana
- M. Nadolski
- M. Nardelli
- M. Nguyen
- M. Numan
- M. Piwowarczyk
- M. Popović
- M. Rajamanickam
- M. Ringvold
- M. Somanath
- M. Soto
- M. Stoerckel
- M. Stošić
- M. Stäuble
- M. Tartaglione
- M. Taylor
- M. Theodoraki
- M. Verdouw
- M. Volfová
- M. Westberg
- M. Wood
- M. Zampieri
- Markovic Bozic
- Martin Ayuso
- Mazul Sunko
- Moro Velasco
- N. Allan
- N. Antunes
- N. Bergmark
- N. Boer
- N. Brohi
- N. Craig
- N. Haldar
- N. Mckee
- N. Richardson
- N. Scalco
- N. Vasconcelos
- Navarro Pérez
- Nesek Adam
- Ní Eochagáin
- O. M. Stell
- O. Hashimi
- O. Kosinová
- O. Kovačević
- O. Marchand
- O. Pohl
- O. Sales
- O. Stanisavljević
- O. Svensen
- P. A. Wade
- P. Achaibar
- P. Anipchenko
- P. Armstrong
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- P. Bishop
- P. Bălan
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- P. Guttenthaler
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- P. Ribeiro
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- R. Kucukguclu
- R. Meço
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- R. Pistidda
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- R. Rasmussen
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- R. Terenzoni
- R. Vullo
- R. Wirth
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- Rafi A.
- Ragazzi R.
- Raineri Santi
- Real Navacerrada
- Ribas Carrasco
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- T. Balaji
- T. Blaylock
- T. Blokhin
- T. Bradley
- T. Branco
- T. Brazzi
- T. Brogly
- T. Butturini
- T. Colvin
- T. Darwish
- T. Dhillon
- T. Gornik-Wlaszczuk
- T. Helliwell
- T. India
- T. Michalov
- T. Moreno
- T. Rajput
- T. Standley
- T. Stanek
- T. Vaida
- T. Vecera
- Tan Hao
- Tardaguila Sancho
- U. Fox
- U. Frasca
- U. Goel
- U. Gupta
- V. Badescu
- V. Barnett
- V. Bartlett
- V. Beauchamp
- V. Cronin
- V. Dîrzu
- V. Fullin
- V. Giles
- V. Gkinas
- V. Gonzalez
- V. Hack
- V. Hanna-Jumma
- V. Irwin
- V. Janez
- V. Kummen
- V. Kuvaki
- V. Lombardi
- V. Marusic-Gaser
- V. Neskovic
- V. Neuwersch
- V. Novakova
- V. Pinol
- V. Schmidt-Ehrenberg
- V. Tarabová
- V. Verri
- Valldeperas Ferrer
- Valldeperas Hernandez
- Van Der Beek
- Van Beek
- Van Dasselaer
- Van Duivenvoorde
- Van Klei
- Van Poorter
- Van Zaane
- Van Zundert
- Van Zyl
- Vargas Munoz
- Vicari Sottosanti
- Vidal Mitjans
- Von Lutterotti
- Von Tiesenhausen
- W. A.
- W. Bukauskas
- Walther Sturesson
- Wegiel Leskiewiq
- Y. Baker
- Y. Hafisayena
- Y. Sanghera
- Z. Gavrilov
- Z. Molin
- Z. Moreno
- Z. Ramachandran
- Zuleika M.
- Zupanĕiĕ D.
- Ö. S. Candeias
- Şanli Karip
- Żukowski M.
- Publication venue
- Publication date
- Field of study
Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications.Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged >= 18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARR(adj)). This study is registered with ClinicalTrials. gov, number NCT01865513.Findings Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7.6%] of 21 694); ORadj 1.86, 95% CI 1.53-2.26; ARR(adj) -4.4%, 95% CI -5.5 to -3.2). Only 2.3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1.31, 95% CI 1.15-1.49; ARR(adj) -2.6%, 95% CI -3.9 to -1.4) and the administration of reversal agents (1.23, 1.07-1.41; -1.9%, -3.2 to -0.7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1.03, 95% CI 0.85-1 center dot 25; ARR(adj) -0.3%, 95% CI -2.4 to 1.5) nor extubation at a train-of-four ratio of 0.9 or more (1.03, 0.82-1.31; -0.4%, -3.5 to 2.2) was associated with better pulmonary outcomes.Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications