8 research outputs found
Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) with Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial
- Author
- Abelha F.
- Abitagaoglu S.
- Achilles M.
- Adam V. N.
- Adebesin A.
- Adriaensens I.
- Ahene C.
- Akbar F.
- Al Kallab R. A. K.
- Albanel X.
- Aldenkortt F.
- Alfouzan R. A. S.
- Alruqaie R.
- Altermatt F.
- Altun G. T.
- Arbesu G.
- Artiles T. S.
- Artsi H.
- Aurilio C.
- Ayanoglu O. H.
- Bacuzzi A.
- Baig H.
- Baird Y.
- Balonov K.
- Balust J.
- Banks S.
- Bao X.
- Barcelos G. K.
- Baumgartner M.
- Bergamaschi A.
- Bergmann L.
- Bigatello L.
- Birr K.
- Bluth T.
- Bobek I.
- Bojaxhi E.
- Bonenti C.
- Bonney I.
- Bos E. M. E.
- Bowman S.
- Braz L. G.
- Brugnoni E.
- Brull S. J.
- Brunetti I.
- Bruni A.
- Buenvenida S. L.
- Busch C. J.
- Cadiz M. J. H.
- Camerini G.
- Canet J. C.
- Capatti B.
- Carmona J.
- Carungcong J.
- Carvalho M.
- Castro D. S.
- Cattan A.
- Cavaleiro C.
- Chiumello D.
- Ciardo S.
- Cinella G.
- Coburn M.
- Colella U.
- Contreras V.
- Cotter E.
- Crovetto M.
- Darrah W.
- Davies S.
- de Baerdemaeker L.
- de Castro Araujo B. L.
- De Hert S.
- de Lemos M. F.
- Delphin E.
- Diaper J.
- Dincer P. C.
- Do Nascimento Junior P.
- Donatiello V.
- Dong J.
- Dourado M. D. S.
- Dullenkopf A.
- Ebner F.
- Elgendy H.
- Ellenberger C.
- Erdogan Ari D.
- Ermert T.
- Farah F.
- Fernandez-Bustamante A.
- Ferreira C.
- Fiore M.
- Fonte A.
- Galimberti A.
- Gama de Abreu M.
- Garofano N.
- Giaccari L. G.
- Gil M. G.
- Gilsanz F.
- Girrbach F.
- Gobbi L.
- Godfried M. B.
- Goettel N.
- Goldstein P. A.
- Gonzalez E. P.
- Goren O.
- Gorlin A.
- Gratarola A.
- Graterol J.
- Gregoretti C.
- Guerrero J. M. T.
- Guyon P.
- Haire K.
- Harbi M. A.
- Harou P.
- Hedenstierna G.
- Helf A.
- Hemmes S. N. T.
- Hempel G.
- Heyse B.
- Hiesmayr M.
- Hollmann M. W.
- Huercio I.
- Ilic M. K.
- Ilievska J.
- Jaber S.
- Jakus L.
- Jeganath V.
- Jelting Y.
- Jung M.
- Kabon B.
- Kacha A.
- Karuppiah A.
- Kavas A. D.
- Kellogg T. A.
- Kemper J.
- Kerbrat R.
- Khodr S.
- Kienbaum P.
- Kir B.
- Kiss T.
- Kivrak S.
- Klaric V.
- Koch T.
- Koksal C.
- Kowark A.
- Kranke P.
- Kuvaki B.
- Kuzmanovska B.
- Laffey J.
- Lange M.
- Licker M. -J.
- Lopez-Baamonde M.
- Lopez-Hernandez A.
- Lopez-Martinez M.
- Luise S.
- Macgregor M.
- Machado H. S.
- Magalhaes D.
- Maillard J.
- Malerbi P.
- Manimekalai N.
- Margarson M.
- Markstaller K.
- Martin A. K.
- Martin D. P.
- Martin Y. N.
- Martin-Loeches I.
- Martinez-Ocon J.
- Maseda E.
- Matot I.
- Mcauliffe N.
- Mckenzie T. J.
- Medina P.
- Meersch M.
- Menzen A.
- Mertens E.
- Meurer B.
- Meyer-Treschan T.
- Miao C.
- Micalizzi C.
- Milic M.
- Mills G. H.
- Modolo N. S. P.
- Moine P.
- Molders P.
- Montero-Feijoo A.
- Moret E.
- Mulier J. P.
- Muller M. K.
- Murphy Z.
- Nalwaya P.
- Naumovski F.
- Navalesi P.
- Navarro E Lima L. H.
- Neumann C.
- Newell C.
- Nisnevitch Z.
- Nizamuddin J.
- Novazzi C.
- Nunes C. S.
- O'Connor M.
- Oprea G.
- Ozbilgin S.
- Pace M. C.
- Pacheco M.
- Packianathaswamy B.
- Palahi C. F.
- Papaspyros F.
- Paredes S.
- Passavanti M. B.
- Peces E. D. C.
- Pedemonte J. C.
- Pelosi P.
- Peremin S.
- Perez E. B.
- Philipsenburg C.
- Pinho D.
- Pinho S.
- Posthuma L. M.
- Pota V.
- Preckel B.
- Priani P.
- Putensen C.
- Rached M. A.
- Radoeshki A.
- Ragazzi R.
- Rajamanickam T.
- Rajamohan A.
- Ramakrishna H.
- Rangarajan D.
- Reiterer C.
- Reynaud T.
- Rhys R.
- Rivas E.
- Robitzky L.
- Ross Renew J.
- Rossaint R.
- Rubulotta F.
- Sabbatini G.
- Samuels J. D.
- Sanahuja J. M.
- Sansone P.
- Santos A.
- Sayedalahl M.
- Schaefer M. S.
- Scharffenberg M.
- Schiffer E.
- Schliewe N.
- Schmitt J.
- Schorer R.
- Schultz M. J.
- Schumann R.
- Selmo G.
- Sendra M.
- Senturk M.
- Serpa Neto A.
- Severgnini P.
- Shaw K.
- Shosholcheva M.
- Sibai A.
- Simon P.
- Simonassi F.
- Sinno C.
- Sivrikoz N.
- Skandalou V.
- Smith N.
- Soares M.
- Sousa M.
- Spadaro S.
- Sprung J.
- Stamatakis E.
- Steiner L. A.
- Stevenazzi A.
- Suarez-De-la-rica A.
- Sungur M. O.
- Suppan M.
- Teichmann R.
- Thiel B.
- Tolos R.
- Tortosa I. B.
- Tucci M.
- Turnbull Z. A.
- Turudic Z.
- Unterberg M.
- Van Limmen J.
- Van Nieuwenhove Y.
- Van Waesberghe J.
- Vidal Melo M. F.
- Vitkovic B.
- Vivona L.
- Vizcaychipi M.
- Volta C. A.
- Weber A.
- Weingarten T. N.
- Wittenstein J.
- Wrigge H.
- Wyffels P.
- Yague J.
- Yates D.
- Yavru A.
- Zac L.
- Zhong J.
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 01/01/2019
- Field of study
Importance: An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain. Objective: To determine whether a higher level of PEEP with alveolar recruitment maneuvers decreases postoperative pulmonary complications in obese patients undergoing surgery compared with a lower level of PEEP. Design, Setting, and Participants: Randomized clinical trial of 2013 adults with body mass indices of 35 or greater and substantial risk for postoperative pulmonary complications who were undergoing noncardiac, nonneurological surgery under general anesthesia. The trial was conducted at 77 sites in 23 countries from July 2014-February 2018; final follow-up: May 2018. Interventions: Patients were randomized to the high level of PEEP group (n = 989), consisting of a PEEP level of 12 cm H2O with alveolar recruitment maneuvers (a stepwise increase of tidal volume and eventually PEEP) or to the low level of PEEP group (n = 987), consisting of a PEEP level of 4 cm H2O. All patients received volume-controlled ventilation with a tidal volume of 7 mL/kg of predicted body weight. Main Outcomes and Measures: The primary outcome was a composite of pulmonary complications within the first 5 postoperative days, including respiratory failure, acute respiratory distress syndrome, bronchospasm, new pulmonary infiltrates, pulmonary infection, aspiration pneumonitis, pleural effusion, atelectasis, cardiopulmonary edema, and pneumothorax. Among the 9 prespecified secondary outcomes, 3 were intraoperative complications, including hypoxemia (oxygen desaturation with Spo2 ≤92% for >1 minute). Results: Among 2013 adults who were randomized, 1976 (98.2%) completed the trial (mean age, 48.8 years; 1381 [69.9%] women; 1778 [90.1%] underwent abdominal operations). In the intention-to-treat analysis, the primary outcome occurred in 211 of 989 patients (21.3%) in the high level of PEEP group compared with 233 of 987 patients (23.6%) in the low level of PEEP group (difference, -2.3% [95% CI, -5.9% to 1.4%]; risk ratio, 0.93 [95% CI, 0.83 to 1.04]; P =.23). Among the 9 prespecified secondary outcomes, 6 were not significantly different between the high and low level of PEEP groups, and 3 were significantly different, including fewer patients with hypoxemia (5.0% in the high level of PEEP group vs 13.6% in the low level of PEEP group; difference, -8.6% [95% CI, -11.1% to 6.1%]; P <.001). Conclusions and Relevance: Among obese patients undergoing surgery under general anesthesia, an intraoperative mechanical ventilation strategy with a higher level of PEEP and alveolar recruitment maneuvers, compared with a strategy with a lower level of PEEP, did not reduce postoperative pulmonary complications. Trial Registration: ClinicalTrials.gov Identifier: NCT02148692
Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients A Randomized Clinical Trial
- Author
- Abelha F
- Abitagaoglu S
- Achilles M
- Adam Vn
- Adebesin A
- Adriaensens I
- Ahene C
- Akbar F
- Al Harbi M
- al Kallab Ra
- Albanel X
- Aldenkortt F
- Alfouzan Ras
- Alruqaie R
- Altermatt F
- Altun Gt
- Araujo Bld
- Arbesu G
- Ari De
- Artiles Ts
- Artsi H
- Aurilio C
- Ayanoglu Oh
- Bacuzzi A
- Baig H
- Baird Y
- Balonov K
- Balust J
- Banks S
- Bao Xd
- Barcelos Gk
- Baumgartner M
- Bergamaschi A
- Bergmann L
- Bigatello L
- Birr K
- Bluth T
- Bluth T
- Bobek I
- Bojaxhi E
- Bonenti C
- Bonney I
- Bos Ee
- Bowman S
- Braz Lg
- Brugnoni E
- Brunetti I
- Bruni A
- Buenvenida Sl
- Cadiz Mjh
- Camerini Cj
- Canet J
- Canet Jc
- Capatti B
- Carmona J
- Carungcong J
- Carvalho M
- Castro Ds
- Cattan A
- Cavaleiro C
- Chiumello D
- Ciardo S
- Coburn M
- Colella U
- Contreras V
- Cotter E
- Crovetto M
- Crovetto W
- Darrah W
- Davies S
- de Abreu Mg
- de Baerdemaeker L
- de Baerdemaeker L
- De Hert S
- de Lemos Mf
- Delphin E
- Diaper J
- Dincer Pc
- do Nascimento P
- Donatiello V
- Dong J
- Dourado Md
- Dullenkopf A
- Ebner F
- Elgendy H
- Ellenberger C
- Ermert T
- Farah F
- Fernandez-Bustamante A
- Ferreira C
- Fiore M
- Fonte A
- Francisco M
- Galimberti A
- Garofano N
- Giaccari Lg
- Gil Mg
- Gilsanz F
- Girrbach F
- Gobbi L
- Godfried Mb
- Goettel N
- Goldstein Pa
- Gonzalez Ep
- Goren O
- Gorlin A
- Gratarola A
- Graterol J
- Gregoretti C
- Guerrero Jmt
- Guyon P
- Haire K
- Harou P
- Hedenstierna G
- Helf A
- Hemmes Snt
- Hemmes Snt
- Hempel G
- Heyse B
- Hiesmayr M
- Hollmann M
- Hollmann Mw
- Huercio I
- Ilic Mk
- Ilievska J
- Jaber S
- Jakus L
- Jeganath V
- Jelting Y
- Jung M
- Kabon B
- Kacha A
- Karuppiah A
- Kavas Ad
- Kellogg Ta
- Kemper J
- Kerbrat R
- Khodr S
- Kienbaum P
- Kir B
- Kiss T
- Kivrak S
- Klaric V
- Koch T
- Koksal C
- Kowark A
- Kranke P
- Kuvaki B
- Kuzmanovska B
- Laffey J
- Laffey J
- Lange M
- Licker Mj
- Licker Mj
- Lima Lhne
- Lopez-Baamonde M
- Lopez-Hernandez A
- Lopez-Martinez M
- Luise S
- Macgregor M
- Machado Hs
- Magalhaes D
- Maillard J
- Malerbi P
- Manimekalai N
- Margarson M
- Markstaller K
- Markstaller K
- Martin Dp
- Martin Yn
- Martin-Loeches I
- Martinez-Ocon J
- Maseda E
- Matot I
- Matot I
- Mcauliffe N
- Mckenzie Tj
- Medina P
- Meersch M
- Melo Mfv
- Melo V
- Menzen A
- Mertens E
- Meurer B
- Meyer-Treschan T
- Miao Ch
- Micalizzi C
- Milic M
- Mills G
- Modolo Nsp
- Moine P
- Molders P
- Montero-Feijoo A
- Moret E
- Mulier Jp
- Muller Mk
- Murphy Z
- Nalwaya P
- Naumovski F
- Navalesi P
- Neto As
- Neumann C
- Newell C
- Nisnevitch Z
- Nizamuddin J
- Novazzi C
- Nunes Cs
- O'Connor M
- Oprea G
- Ozbilgin S
- Pace Mc
- Pacheco M
- Packianathaswamy B
- Palahi Cf
- Papaspyros F
- Paredes S
- Passavanti Mb
- Peces Ed
- Pedemonte Jc
- Pelosi P
- Pelosi P
- Peremin S
- Perez Eb
- Philipsenburg C
- Pinho D
- Pinho S
- Posthuma Lm
- Pota V
- Preckel B
- Priani P
- Putensen C
- Putensen C
- Rached Ma
- Radoeshki A
- Ragazzi R
- Rajamanickam T
- Rajamohan A
- Ramakrishna H
- Rangarajan D
- Reiterer C
- Renew Jr
- Reynaud T
- Rhys R
- Rivas E
- Robitzky L
- Rossaint R
- Rossaint R
- Rubulotta F
- Sabbatini G
- Sanahuja Jm
- Sansone P
- Santos A
- Sayedalahl M
- Schaefer Ms
- Scharffenberg E
- Scharffenberg M
- Schiffer E
- Schliewe N
- Schmitt J
- Schorer R
- Schultz Mj
- Schultz Mj
- Schumann R
- Selmo G
- Sendra M
- Senturk M
- Senturk M
- Severgnini P
- Severgnini P
- Shaw K
- Shosholcheva M
- Sibai A
- Simon P
- Simonassi F
- Sinno C
- Sivrikoz N
- Skandalou V
- Smith N
- Soares M
- Sousa M
- Spadaro S
- Sprung J
- Sprung J
- Stamatakis E
- Steiner La
- Stevenazzi A
- Suarez-de-la-Rica A
- Sungur Mo
- Suppan M
- Teichmann R
- Thiel B
- Tolos R
- Tortosa Ib
- Tucci M
- Turnbull Za
- Turudic Z
- Unterberg M
- Van Limmen J
- Van Nieuwenhove Y
- Van Waesberghe J
- Vitkovic B
- Vivona L
- Vizcaychipi M
- Volta Ca
- Weber A
- Weingarten Tn
- Wittenstein J
- Wrigge H
- Wrigge H
- Wyffels P
- Yague J
- Yates D
- Yavru A
- Zac L
- Zhong J
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 01/01/2019
- Field of study
Mortality after surgery in Europe: a 7 day cohort study
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- Aakeroey K
- Acan I
- Adams D
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- Adolfsson A
- Afonso O
- Afshari A
- Agarwal B
- Agnic I
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- 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
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- Alvarez LR
- Amaniti E
- Amatya S
- Ampuero MS
- Anchuelo AH
- Andabaka T
- Andersen JD
- Anderson H
- Andresen B
- Angulo GO
- Anna US
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- Aracil N
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- Arawwawala D
- Arcas JJ
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- Arpino I
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- Arteta DA
- Artigas A
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- Arviza LP
- Asensio MA
- Assunção JP
- Aubrun F
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- Austine P
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- Axelsson P
- Ayman M
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- Barr K
- Barrachima BB
- Barrasa H
- Barrios F
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- Barthel F
- Bartolomé MJ
- Bataillard A
- Batchelor N
- Bates D
- Batinica IM
- Battistella M
- Bauer P
- Bauer W
- Bauer ZŠ
- 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
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- Benayoun L
- Bento HC
- Bento L
- Bergamini E
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- Bergin A
- Bermejo FJ
- Bernal DG
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- De Wit E
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- Debelic D
- Debernardi F
- Del Olmo M
- Delgado FC
- Delgado HG
- Delgado TR
- Delic N
- Dell'unto S
- DELLA CORTE Francesco
- 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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- Dinescu SA
- Dinu M
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- Dokka V
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- Drab M
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- Dragulescu D
- Dražen B
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- Drescher J
- Dresden C
- Dropulic N
- Druwé P
- Dubois Vallaud D
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- Dunne K
- Duque P
- Durán MV
- Duzel V
- Dušanka K
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- Díaz TD
- Díez EP
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- Elisei D
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- ElMiloudi F
- Elomaa E
- Elson MZ
- Elvira MA
- Elósegui I
- Engelen WC
- Epure F
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- Erkens U
- Erler I
- Ernst S
- Espinosa E
- Espinosa N
- Esteruelas JA
- Esteva GE
- Esteves F
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- Falk I
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- Farnia A
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- Feld F
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- Fernández LF
- Fernández PT
- Fernández SR
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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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- 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
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- \u160aric JP
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- Westbrook A
- Westbrook A
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- Publication venue
- Publication date
- 01/01/2012
- Field of study
Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial.
- Author
- Abelha Fernando
- Abitagaoglu Suhayla
- Achilles Marc
- Adam Visnja Nesek
- Adebesin Afeez
- Adriaensens Ine
- Ahene Charles
- Akbar Fatima
- Al Harbi Mohammed
- al Kallab Rita Al Khoury
- Albanel Xavier
- Aldenkortt Florence
- Alfouzan Rawan Abdullah Saleh
- Alruqaie Reef
- Altermatt Fernando
- Altun Gulbin Tore
- Araujo Bruno Luis de Castro
- Arbesu Genaro
- Ari Dilek Erdogan
- Artiles Tania Socorro
- Artsi Hanna
- Aurilio Caterina
- Ayanoglu Omer Hilmi
- Bacuzzi Alessandro
- Baig Harris
- Baird Yolanda
- Balonov Konstantin
- Balust Jaume
- Banks Samantha
- Bao Xiaodong
- Barcelos Gleicy Keli
- Baumgartner Melanie
- Bergamaschi Alice
- Bergmann Lars
- Bigatello Luca
- Birr Katja
- Bluth Thomas
- Bluth Thomas
- Bobek Ilona
- Bojaxhi Elird
- Bonenti Chiara
- Bonney Iwona
- Bos Elkem. E.
- Bowman Sara
- Braz Leandro Gobbo
- Brugnoni Elisa
- Brunetti Iole
- Bruni Andrea
- Buenvenida Shonie L.
- Cadiz Maria Jose Hernandez
- Camerini Cornelius Johannes
- Canet Jaume
- Canet Jaume C.
- Capatti Beatrice
- Carmona Javiera
- Carungcong Jaime
- Carvalho Marta
- Castro Diogo Sousa
- Cattan Anat
- Cavaleiro Carla
- Chiumello Davide
- Ciardo Stefano
- Coburn Mark
- Colella Umberto
- Contreras Victor
- Cotter Elizabeth
- Crovetto Marcia
- Crovetto William
- Darrah William
- Davies Simon
- de Abreu Marcelo Gama
- de Baerdemaeker Luc
- de Baerdemaeker Luc
- De Hert Stefan
- de Lemos Marilia Freitas
- Delphin Ellise
- Diaper John
- Dincer Pelin Corman
- do Nascimento Junior Paulo
- Donatiello Valerio
- Dong Jing
- Dourado Maria do Socorro
- Dullenkopf Alexander
- Ebner Felix
- Elgendy Hamed
- Ellenberger Christoph
- Ermert Thomas
- Farah Fadi
- Fernandez-Bustamante Ana
- Ferreira Cristina
- Fiore Marco
- Fonte Ana
- Francisco Marcos
- Galimberti Andrea
- Garofano Najia
- Giaccari Luca Gregorio
- Gil Manuel Granell
- Gilsanz Fernando
- Girrbach Felix
- Gobbi Luca
- Godfried Marc Bernard
- Goettel Nicolai
- Goldstein Peter A.
- Gonzalez Estefania Palma
- Goren Or
- Gorlin Andrew
- Gratarola Angelo
- Graterol Juan
- Gregoretti Cesare
- Guerrero Jose Maria Tena
- Guyon Pierre
- Haire Kevin
- Harou Philippe
- Hedenstierna Goran
- Helf Antonia
- Hemmes Sabrine N. T.
- Hemmes Sabrine N. T.
- Hempel Gunther
- Heyse Bjorn
- Hiesmayr Michael
- Hollmann Markus
- Hollmann Markus W.
- Huercio Ivan
- Ilic Maja Karaman
- Ilievska Jasmina
- Jaber Samir
- Jakus Lien
- Jeganath Vijay
- Jelting Yvonne
- Jung Minoa
- Kabon Barbara
- Kacha Aalok
- Karuppiah Arunthevaraja
- Kavas Ayse Duygu
- Kellogg Todd A.
- Kemper Johann
- Kerbrat Romain
- Khodr Suraya
- Kienbaum Peter
- Kir Bunyamin
- Kiss Thomas
- Kivrak Selin
- Klaric Vlasta
- Koch Thea
- Koksal Ceren
- Kowark Ana
- Kranke Peter
- Kuvaki Bahar
- Kuzmanovska Biljana
- Laffey John
- Laffey John
- Lange Mirko
- Licker Marc J.
- Licker Marc-Joseph
- Lopez-Baamonde Manuel
- Lopez-Hernandez Antonio
- Lopez-Martinez Mercedes
- Luise Stephane
- MacGregor Mark
- Machado Humberto S.
- Magalhaes Danielle
- Maillard Julien
- Malerbi Patrizia
- Manimekalai Natesan
- Margarson Michael
- Markstaller Klaus
- Markstaller Klaus
- Martin David P.
- Martin Yvette N.
- Martin-Loeches Ignacio
- Martinez-Ocon Julia
- Maseda Emilio
- Matot Idit
- Matot Idit
- McAuliffe Niamh
- McKenzie Travis J.
- Medina Paulina
- Meersch Melanie
- Melo Marcos Francisco Vidal
- Melo Vidal
- Menzen Angelika
- Mertens Els
- Meurer Bernd
- Meyer-Treschan Tanja
- Miao Changhong
- Micalizzi Camilla
- Milic Morena
- Mills Gary
- Modolo Norma Sueli Pinheiro
- Moine Pierre
- Molders Patrick
- Montero-Feijoo Ana
- Moret Enrique
- Mulier Jan Paul
- Muller Markus K.
- Murphy Zoe
- Nalwaya Pramod
- Naumovski Filip
- Navalesi Paolo
- Navarro e Lima Lais Helena
- Neumann Claudia
- Newell Christopher
- Nisnevitch Zoulfira
- Nizamuddin Junaid
- Novazzi Cecilia
- Nunes Catarina S.
- O'Connor Michael
- Oprea Gunther
- Ozbilgin Sule
- Pace Maria Caterina
- Pacheco Marcos
- Packianathaswamy Balaji
- Palahi Christina Fortia
- Papaspyros Fotios
- Paredes Sebastian
- Passavanti Maria Beatrice
- Peces Enrique Del Cojo
- Pedemonte Juan Cristobal
- Pelosi Paolo
- Pelosi Paolo
- Peremin Sanja
- Perez Elena Biosca
- Philipsenburg Christoph
- Pinho Daniela
- Pinho Silvia
- Posthuma Linda M.
- Pota Vincenzo
- Preckel Benedikt
- Priani Paolo
- Putensen Christian
- Putensen Christian
- Rached Mohamed Aymen
- Radoeshki Aleksandar
- Ragazzi Riccardo
- Rajamanickam Tamilselvan
- Rajamohan Arthi
- Ramakrishna Harish
- Rangarajan Desikan
- Reiterer Christian
- Renew J. Ross
- Reynaud Thomas
- Rhys Rhidian
- Rivas Eva
- Robitzky Luisa
- Rossaint Rolf
- Rossaint Rolf
- Rubulotta Francesca
- Sabbatini Giovanni
- Sanahuja Josep Marti
- Sansone Pasquale
- Santos Alice
- Sayedalahl Mohamed
- Schaefer Maximilian S.
- Scharffenberg Eduardo
- Scharffenberg Martin
- Schiffer Eduardo
- Schliewe Nadja
- Schmitt Jochen
- Schorer Raoul
- Schultz Marcus J.
- Schultz Marcus J.
- Schumann Roman
- Selmo Gabriele
- Sendra Mar
- Senturk Mert
- Senturk Mert
- Serpa Neto Ary
- Severgnini Paolo
- Severgnini Paolo
- Shaw Kate
- Shosholcheva Mirjana
- Sibai Abdulrazak
- Simon Philipp
- Simonassi Francesca
- Sinno Claudia
- Sivrikoz Nukhet
- Skandalou Vasiliki
- Smith Neil
- Soares Maria
- Sousa Miguel
- Spadaro Savino
- Sprung Juraj
- Sprung Juraj
- Stamatakis Emmanouil
- Steiner Luzius A.
- Stevenazzi Andrea
- Suarez-de-la-Rica Alejandro
- Sungur Mukadder
- Suppan Melanie
- Teichmann Robert
- Thiel Bram
- Tolos Raquel
- Tortosa Isabel Belda
- Tucci Michelle
- Turnbull Zachary A.
- Turudic Zana
- Unterberg Matthias
- Van Limmen Jurgen
- Van Nieuwenhove Yves
- Van Waesberghe Julia
- Vitkovic Bibiana
- Vivona Luigi
- Vizcaychipi Marcela
- Volta Carlo Alberto
- Weber Anne
- Weingarten Toby N.
- Wittenstein Jakob
- Wrigge Hermann
- Wrigge Hermann
- Wyffels Piet
- Yague Julio
- Yates David
- Yavru Aysen
- Zac Lilach
- Zhong Jing
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 03/03/2021
- Field of study
IMPORTANCE An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain
Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial (vol 321, pg 2292, 2019)
- Author
- Abelha Fernando
- Abitagaoglu Suhayla
- Achilles Marc
- Adam Visnja Nesek
- Adebesin Afeez
- Adriaensens Ine
- Ahene Charles
- Akbar Fatima
- Al Harbi Mohammed
- al Kallab Rita Al Khoury
- Albanel Xavier
- Aldenkortt Florence
- Alfouzan Rawan Abdullah Saleh
- Alruqaie Reef
- Altermatt Fernando
- Altun Gulbin Tore
- Araujo Bruno Luis de Castro
- Arbesu Genaro
- Ari Dilek Erdogan
- Artiles Tania Socorro
- Artsi Hanna
- Aurilio Caterina
- Ayanoglu Omer Hilmi
- Bacuzzi Alessandro
- Baig Harris
- Baird Yolanda
- Balonov Konstantin
- Balust Jaume
- Banks Samantha
- Bao Xiaodong
- Barcelos Gleicy Keli
- Baumgartner Melanie
- Bergamaschi Alice
- Bergmann Lars
- Bigatello Luca
- Birr Katja
- Bluth Thomas
- Bluth Thomas
- Bluth Thomas
- Bluth Thomas
- Bobek Ilona
- Bobek Ilona
- Bojaxhi Elird
- Bonenti Chiara
- Bonney Iwona
- Bos Elke ME
- Bowman Sara
- Braz Leandro Gobbo
- Brugnoni Elisa
- Brull Sorin J
- Brunetti Iole
- Bruni Andrea
- Buenvenida Shonie L
- Busch Cornelius Johannes
- Cadiz Maria Jose Hernandez
- Camerini Giovanni
- Canet Jaume C
- Canet Jaume C
- Capatti Beatrice
- Carmona Javiera
- Carungcong Jaime
- Carvalho Marta
- Castro Diogo Sousa
- Cattan Anat
- Cavaleiro Carla
- Chiumello Davide
- Ciardo Stefano
- Cinella Gilda
- Coburn Mark
- Colella Umberto
- Contreras Victor
- Cotter Elizabeth
- Crovetto Marcia
- Darrah William
- Davies Simon
- de Abreu Marcelo Gama
- de Abreu Marcelo Gama
- de Abreu Marcelo Gama
- de Abreu Marcelo Gama
- de Baerdemaeker Luc
- de Baerdemaeker Luc
- De Hert Stefan
- de Lemos Marilia Freitas
- Delphin Ellise
- Diaper John
- Dincer Pelin Corman
- do Nascimento Junior Paulo
- Donatiello Valerio
- Dong Jing
- Dourado Maria do Socorro
- Dullenkopf Alexander
- Ebner Felix
- Elgendy Hamed
- Ellenberger Christoph
- Ermert Thomas
- Farah Fadi
- Fernandez-Bustamante Ana
- Ferreira Cristina
- Fiore Marco
- Fonte Ana
- Galimberti Andrea
- Garofano Najia
- Giaccari Luca Gregorio
- Gil Manuel Granell
- Gilsanz Fernando
- Girrbach Felix
- Gobbi Luca
- Godfried Marc Bernard
- Goettel Nicolai
- Goldstein Peter A
- Gonzalez Estefania Palma
- Goren Or
- Gorlin Andrew
- Gratarola Angelo
- Graterol Juan
- Gregoretti Cesare
- Gregoretti Cesare
- Guerrero Jose Maria Tena
- Guyon Pierre
- Haire Kevin
- Harou Philippe
- Hedenstierna Goran
- Hedenstierna Goran
- Helf Antonia
- Hemmes Sabrine NT
- Hemmes Sabrine NT
- Hempel Gunther
- Heyse Bjorn
- Hiesmayr Michael
- Hiesmayr Michael
- Hollmann Markus W
- Hollmann Markus W
- Huercio Ivan
- Ilic Maja Karaman
- Ilievska Jasmina
- Jaber Samir
- Jaber Samir
- Jakus Lien
- Jeganath Vijay
- Jelting Yvonne
- Jung Minoa
- Kabon Barbara
- Kacha Aalok
- Karuppiah Arunthevaraja
- Kavas Ayse Duygu
- Kellogg Todd A
- Kemper Johann
- Kerbrat Romain
- Khodr Suraya
- Kienbaum Peter
- Kir Bunyamin
- Kiss Thomas
- Kivrak Selin
- Klaric Vlasta
- Koch Thea
- Koksal Ceren
- Kowark Ana
- Kranke Peter
- Kuvaki Bahar
- Kuzmanovska Biljana
- Laffey John
- Laffey John
- Lange Mirko
- Licker Marc-Joseph
- Licker Marc-Joseph
- Lopez-Baamonde Manuel
- Lopez-Hernandez Antonio
- Lopez-Martinez Mercedes
- Luise Stephane
- MacGregor Mark
- Machado Humberto S
- Magalhaes Danielle
- Maillard Julien
- Malerbi Patrizia
- Manimekalai Natesan
- Margarson Michael
- Markstaller Klaus
- Markstaller Klaus
- Martin Archer K
- Martin Archer K
- Martin David P
- Martin Yvette N
- Martin-Loeches Ignacio
- Martinez-Ocon Julia
- Maseda Emilio
- Matot Idit
- Matot Idit
- McAuliffe Niamh
- McKenzie Travis J
- Medina Paulina
- Meersch Melanie
- Melo Marcos Francisco Vidal
- Melo Marcos Francisco Vidal
- Menzen Angelika
- Mertens Els
- Meurer Bernd
- Meyer-Treschan Tanja
- Miao Changhong
- Micalizzi Camilla
- Milic Morena
- Mills Gary H
- Mills Gary H
- Modolo Norma Sueli Pinheiro
- Moine Pierre
- Molders Patrick
- Montero-Feijoo Ana
- Moret Enrique
- Mulier Jan Paul
- Mulier Jan Paul
- Muller Markus K
- Murphy Zoe
- Nalwaya Pramod
- Naumovski Filip
- Navalesi Paolo
- Navarro e Lima Lais Helena
- Neumann Claudia
- Newell Christopher
- Nisnevitch Zoulfira
- Nizamuddin Junaid
- Novazzi Cecilia
- Nunes Catarina S
- O'Connor Michael
- Oprea Gunther
- Ozbilgin Sule
- Pace Maria Caterina
- Pacheco Marcos
- Packianathaswamy Balaji
- Palahi Christina Fortia
- Papaspyros Fotios
- Paredes Sebastian
- Passavanti Maria Beatrice
- Peces Enrique Del Cojo
- Pedemonte Juan Cristobal
- Pelosi Paolo
- Pelosi Paolo
- Pelosi Paolo
- Peremin Sanja
- Perez Elena Biosca
- Philipsenburg Christoph
- Pinho Daniela
- Pinho Silvia
- Posthuma Linda M
- Pota Vincenzo
- Preckel Benedikt
- Priani Paolo
- Putensen Christian
- Putensen Christian
- Rached Mohamed Aymen
- Radoeshki Aleksandar
- Ragazzi Riccardo
- Rajamanickam Tamilselvan
- Rajamohan Arthi
- Ramakrishna Harish
- Rangarajan Desikan
- Reiterer Christian
- Renew J Ross
- Reynaud Thomas
- Rhys Rhidian
- Rivas Eva
- Robitzky Luisa
- Rossaint Rolf
- Rossaint Rolf
- Rubulotta Francesca
- Sabbatini Giovanni
- Samuels Jon D
- Sanahuja Josep Marti
- Sansone Pasquale
- Santos Alice
- Sayedalahl Mohamed
- Schaefer Maximilian S
- Scharffenberg Martin
- Schiffer Eduardo
- Schliewe Nadja
- Schmitt Jochen
- Schmitt Jochen
- Schorer Raoul
- Schultz Marcus J
- Schultz Marcus J
- Schultz Marcus J
- Schumann Roman
- Selmo Gabriele
- Sendra Mar
- Senturk Mert
- Senturk Mert
- Serpa Neto Ary
- Serpa Neto Ary
- Serpa Neto Ary
- Severgnini Paolo
- Severgnini Paolo
- Shaw Kate
- Shosholcheva Mirjana
- Sibai Abdulrazak
- Simon Philipp
- Simonassi Francesca
- Sinno Claudia
- Sivrikoz Nukhet
- Skandalou Vasiliki
- Smith Neil
- Soares Maria
- Sousa Miguel
- Spadaro Savino
- Sprung Juraj
- Sprung Juraj
- Stamatakis Emmanouil
- Steiner Luzius A
- Stevenazzi Andrea
- Suarez-de-la-Rica Alejandro
- Sungur Mukadder Orhan
- Suppan Melanie
- Teichmann Robert
- Thiel Bram
- Tolos Raquel
- Tortosa Isabel Belda
- Tucci Michelle
- Turnbull Zachary A
- Turudic Zana
- Unterberg Matthias
- Van Limmen Jurgen
- Van Nieuwenhove Yves
- Van Waesberghe Julia
- Vitkovic Bibiana
- Vivona Luigi
- Vizcaychipi Marcela
- Volta Carlo Alberto
- Weber Anne
- Weingarten Toby N
- Wittenstein Jakob
- Wrigge Hermann
- Wrigge Hermann
- Wyffels Piet
- Yague Julio
- Yates David
- Yavru Aysen
- Zac Lilach
- Zhong Jing
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 12/11/2019
- Field of study
status: publishe
Effect of intraoperative high Positive End-Expiratory Pressure (PEEP) with recruitment maneuvers vs low PEEP on postoperative pulmonary complications in obese patients : a randomized clinical trial
- Author
- Abelha Fernando
- Abitagaoglu Suhayla
- Achilles Marc
- Adebesin Afeez
- Adriaensens Ine
- Ahene Charles
- Akbar Fatima
- Al Harbi Mohammed
- al Kallab Rita Al Khoury
- Albanel Xavier
- Aldenkortt Florence
- Alfouzan Rawan Abdullah Saleh
- Alruqaie Reef
- Altermatt Fernando
- Araujo Bruno Luis de Castro
- Arbesu Genaro
- Ari Dilek Erdogan
- Artsi Hanna
- Aurilio Caterina
- Ayanoglu Omer Hilmi
- Bacuzzi Alessandro
- Baig Harris
- Baird Yolanda
- Balonov Konstantin
- Balust Jaume
- Banks Samantha
- Bao Xiaodong
- Baumgartner Melanie
- Bergamaschi Alice
- Bergmann Lars
- Bigatello Luca
- Biosca Perez Elena
- Birr Katja
- Bluth Thomas
- Bluth Thomas
- Bobek Ilona
- Bojaxhi Elird
- Bonenti Chiara
- Bonney Iwona
- Bos Elkem. E
- Bowman Sara
- Braz Leandro Gobbo
- Brugnoni Elisa
- Brunetti Iole
- Bruni Andrea
- Buenvenida Shonie L
- Cadiz Maria Jose Hernandez
- Camerini Cornelius Johannes
- Canet Jaume
- Canet Jaume C
- Capatti Beatrice
- Carmona Javiera
- Carungcong Jaime
- Carvalho Marta
- Cattan Anat
- Cavaleiro Carla
- Chiumello Davide
- Ciardo Stefano
- Coburn Mark
- Colella Umberto
- Contreras Victor
- Corman Dincer Pelin
- Cotter Elizabeth
- Crovetto Marcia
- Crovetto William
- Darrah William
- Davies Simon
- de Abreu Marcelo Gama
- De Baerdemaeker Luc
- De Baerdemaeker Luc
- De Hert Stefan
- de Lemos Marilia Freitas
- Delphin Ellise
- Diaper John
- do Nascimento Junior Paulo
- Donatiello Valerio
- Dong Jing
- Dourado Maria do Socorro
- Dullenkopf Alexander
- Ebner Felix
- Elgendy Hamed
- Ellenberger Christoph
- Ermert Thomas
- Farah Fadi
- Fernandez-Bustamante Ana
- Ferreira Cristina
- Fiore Marco
- Fonte Ana
- Fortia Palahi Christina
- Francisco Marcos
- Galimberti Andrea
- Garofano Najia
- Giaccari Luca Gregorio
- Gil Manuel Granell
- Gilsanz Fernando
- Girrbach Felix
- Gobbi Luca
- Godfried Marc Bernard
- Goettel Nicolai
- Goldstein Peter A
- Goren Or
- Gorlin Andrew
- Gratarola Angelo
- Graterol Juan
- Gregoretti Cesare
- Guyon Pierre
- Haire Kevin
- Harou Philippe
- Hedenstierna Goran
- Helf Antonia
- Hemmes Sabrine NT
- Hemmes Sabrine NT
- Hempel Gunther
- Heyse Bjorn
- Hiesmayr Michael
- Hollmann Markus
- Hollmann Markus W
- Huercio Ivan
- Ilievska Jasmina
- Jaber Samir
- Jakus Lien
- Jeganath Vijay
- Jelting Yvonne
- Jung Minoa
- Kabon Barbara
- Kacha Aalok
- Karaman Ilic Maja
- Karuppiah Arunthevaraja
- Kavas Ayse Duygu
- Keli Barcelos Gleicy
- Kellogg Todd A
- Kemper Johann
- Kerbrat Romain
- Khodr Suraya
- Kienbaum Peter
- Kir Bunyamin
- Kiss Thomas
- Kivrak Selin
- Klaric Vlasta
- Koch Thea
- Koksal Ceren
- Kowark Ana
- Kranke Peter
- Kuvaki Bahar
- Kuzmanovska Biljana
- Laffey John
- Laffey John
- Lange Mirko
- Licker Marc J
- Licker Marc-Joseph
- Lopez-Baamonde Manuel
- Lopez-Hernandez Antonio
- Lopez-Martinez Mercedes
- Luise Stephane
- MacGregor Mark
- Machado Humberto S
- Magalhaes Danielle
- Maillard Julien
- Malerbi Patrizia
- Manimekalai Natesan
- Margarson Michael
- Markstaller Klaus
- Markstaller Klaus
- Martin David P
- Martin Yvette N
- Martin-Loeches Ignacio
- Martinez-Ocon Julia
- Maseda Emilio
- Matot Idit
- Matot Idit
- McAuliffe Niamh
- McKenzie Travis J
- Medina Paulina
- Meersch Melanie
- Melo Marcos Francisco Vidal
- Melo Vidal
- Menzen Angelika
- Mertens Els
- Meurer Bernd
- Meyer-Treschan Tanja
- Miao Changhong
- Micalizzi Camilla
- Milic Morena
- Mills Gary
- Modolo Norma Sueli Pinheiro
- Moine Pierre
- Molders Patrick
- Montero-Feijoo Ana
- Moret Enrique
- Mulier Jan Paul
- Muller Markus K
- Murphy Zoe
- Nalwaya Pramod
- Naumovski Filip
- Navalesi Paolo
- Navarro e Lima Lais Helena
- Nesek Adam Visnja
- Neumann Claudia
- Newell Christopher
- Nisnevitch Zoulfira
- Nizamuddin Junaid
- Novazzi Cecilia
- Nunes Catarina S
- O'Connor Michael
- Oprea Gunther
- Orhan Sungur Mukadder
- Ozbilgin Sule
- Pace Maria Caterina
- Pacheco Marcos
- Packianathaswamy Balaji
- Palma Gonzalez Estefania
- Papaspyros Fotios
- Paredes Sebastian
- Passavanti Maria Beatrice
- Peces Enrique Del Cojo
- Pedemonte Juan Cristobal
- Pelosi Paolo
- Pelosi Paolo
- Peremin Sanja
- Philipsenburg Christoph
- Pinho Daniela
- Pinho Silvia
- Posthuma Linda M
- Pota Vincenzo
- Preckel Benedikt
- Priani Paolo
- Putensen Christian
- Putensen Christian
- Rached Mohamed Aymen
- Radoeshki Aleksandar
- Ragazzi Riccardo
- Rajamanickam Tamilselvan
- Rajamohan Arthi
- Ramakrishna Harish
- Rangarajan Desikan
- Reiterer Christian
- Renew J Ross
- Reynaud Thomas
- Rhys Rhidian
- Rivas Eva
- Robitzky Luisa
- Rossaint Rolf
- Rossaint Rolf
- Rubulotta Francesca
- Sabbatini Giovanni
- Sanahuja Josep Marti
- Sansone Pasquale
- Santos Alice
- Sayedalahl Mohamed
- Schaefer Maximilian S
- Scharffenberg Eduardo
- Scharffenberg Martin
- Schiffer Eduardo
- Schliewe Nadja
- Schmitt Jochen
- Schorer Raoul
- Schultz Marcus J
- Schultz Marcus J
- Schumann Roman
- Selmo Gabriele
- Sendra Mar
- Senturk Mert
- Senturk Mert
- Serpa Neto Ary
- Severgnini Paolo
- Severgnini Paolo
- Shaw Kate
- Shosholcheva Mirjana
- Sibai Abdulrazak
- Simon Philipp
- Simonassi Francesca
- Sinno Claudia
- Sivrikoz Nukhet
- Skandalou Vasiliki
- Smith Neil
- Soares Maria
- Socorro Artiles Tania
- Sousa Castro Diogo
- Sousa Miguel
- Spadaro Savino
- Sprung Juraj
- Sprung Juraj
- Stamatakis Emmanouil
- Steiner Luzius A
- Stevenazzi Andrea
- Suarez-de-la-Rica Alejandro
- Suppan Melanie
- Teichmann Robert
- Tena Guerrero Jose Maria
- Thiel Bram
- Tolos Raquel
- Tore Altun Gulbin
- Tortosa Isabel Belda
- Tucci Michelle
- Turnbull Zachary A
- Turudic Zana
- Unterberg Matthias
- Van Limmen Jurgen
- Van Nieuwenhove Yves
- Van Waesberghe Julia
- Vitkovic Bibiana
- Vivona Luigi
- Vizcaychipi Marcela
- Volta Carlo Alberto
- Weber Anne
- Weingarten Toby N
- Wittenstein Jakob
- Wrigge Hermann
- Wrigge Hermann
- WYFFELS PIET
- Yague Julio
- Yates David
- Yavru Aysen
- Zac Lilach
- Zhong Jing
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 01/01/2019
- Field of study
IMPORTANCE An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain.
OBJECTIVE To determine whether a higher level of PEEP with alveolar recruitment maneuvers decreases postoperative pulmonary complications in obese patients undergoing surgery compared with a lower level of PEEP.
DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 2013 adults with body mass indices of 35 or greater and substantial risk for postoperative pulmonary complications who were undergoing noncardiac, nonneurological surgery under general anesthesia. The trial was conducted at 77 sites in 23 countries from July 2014-February 2018; final follow-up: May 2018.
INTERVENTIONS Patients were randomized to the high level of PEEP group (n = 989), consisting of a PEEP level of 12 cm H2O with alveolar recruitment maneuvers (a stepwise increase of tidal volume and eventually PEEP) or to the low level of PEEP group (n = 987), consisting of a PEEP level of 4 cm H2O. All patients received volume-controlled ventilation with a tidal volume of 7 mL/kg of predicted body weight.
MAIN OUTCOMES AND MEASURES The primary outcomewas a composite of pulmonary complications within the first 5 postoperative days, including respiratory failure, acute respiratory distress syndrome, bronchospasm, new pulmonary infiltrates, pulmonary infection, aspiration pneumonitis, pleural effusion, atelectasis, cardiopulmonary edema, and pneumothorax. Among the 9 prespecified secondary outcomes, 3 were intraoperative complications, including hypoxemia (oxygen desaturation with SpO(2) 1 minute).
RESULTS Among 2013 adults who were randomized, 1976 (98.2%) completed the trial (mean age, 48.8 years; 1381 [69.9%] women; 1778 [90.1%] underwent abdominal operations). In the intention-to-treat analysis, the primary outcome occurred in 211 of 989 patients (21.3%) in the high level of PEEP group compared with 233 of 987 patients (23.6%) in the low level of PEEP group (difference, -2.3%[95% CI, -5.9% to 1.4%]; risk ratio, 0.93 [95% CI, 0.83 to 1.04]; P =.23). Among the 9 prespecified secondary outcomes, 6 were not significantly different between the high and low level of PEEP groups, and 3 were significantly different, including fewer patients with hypoxemia (5.0% in the high level of PEEP group vs 13.6% in the low level of PEEP group; difference, -8.6%[95% CI, -11.1% to 6.1%]; P <.001).
CONCLUSIONS AND RELEVANCE Among obese patients undergoing surgery under general anesthesia, an intraoperative mechanical ventilation strategy with a higher level of PEEP and alveolar recruitment maneuvers, compared with a strategy with a lower level of PEEP, did not reduce postoperative pulmonary complications
Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical trials.
- Author
- Abelha Fernando
- Abitağaoğlu Sühayla
- Achilles Marc
- Acosta Jesús
- Adam Višnja Nesek
- Adebesin Afeez
- Adriaensens Ine
- Agilaga Marta
- Aguilar Gerardo
- Ahene Charles
- Akbar Fatima
- Al Harbi Mohammed
- Al Khoury Al Kallab Rita
- Albanel Xavier
- Alberola María José
- Alcón Amalia
- Aldecoa César
- Aldenkortt Florence
- Alonso Jose M
- Alonso María Dolores
- Alruqaie Reef
- Altermatt Fernando
- Altun Gulbin Tore
- Amantea Bruno
- Anaya Rafael
- Arbesú Genaro
- Argente María Pilar
- Arı Dilek Erdoğan
- Arocas Blanca
- Artiles Tania Socorro
- Artsi Hanna
- Asensio Ana
- Aurilio Caterina
- Ayanoglu Omer Hilmi
- Ayas Begoña
- Ayuso Mercedes
- Azparren Gonzalo
- Bacuzzi Alessandro
- Bacuzzi Alessandro
- Baig Harris
- Baird Yolanda
- Balandrón Victor
- Ball Lorenzo
- Balonov Konstantin
- Balust Jaume
- Balust Jaume
- Banks Samantha
- Bao Xiaodong
- Barberis Bruno
- Barcelos Gleicy Keli
- Barrio María
- Barrios Francisco
- Bastin Bea
- Baumgartner Mélanie
- Bejarano Natalia
- Belda Javier
- Benítez Inmaculada
- Bergamaschi Alice
- Bergmann Lars
- Bigatello Luca
- Binnekade Jan M
- Birr Katja
- Bluth Thomas
- Bluth Thomas
- Bluth Thomas
- Bodger Phoebe
- Bojaxhi Elird
- Bonenti Chiara
- Bonney Iwona
- Bos Elke M E
- Bos Lieuwe Dj
- Bowman Sara
- Braz Leandro Gobbo
- Brodhun Alexander
- Brugnoni Elisa
- Brull Sorin J
- Brunelli Andrea
- Brunelli Andrea
- Brunetti Iole
- Bruni Andrea
- Buenvenida Shonie L
- Bugedo Guillermo
- Busch Cornelius Johannes
- Cabrera Sergio
- Caggianelli Girolamo
- Camerini Giovanni
- Campos Niklas S
- Canet Jaume
- Canet Jaume
- Canet Jaume
- Capatti Beatrice
- Carbonell Jose A
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- Caroleo Santo
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- Hernández Samuel
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- Özbilgin ŞULE
- Publication venue
- Publication date
- 01/06/2022
- Field of study