The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.

Mazzinari, G; Neto, AS; Hemmes, SNT; Hedenstierna, G; Jaber, S; Hiesmayr, M; Hollmann, MW; Mills, GH; Melo, MFV; Pearse, RM; Putensen, C; Schmid, W; Severgnini, P; Wrigge, H; Cambronero, OD; Ball, L; de Abreu, MG; Pelosi, P; Schultz, MJ; LAS VEGAS Study-Iinvestigators; PROtective VEntilation Network; European Soc Anaesthesiology

The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.

BACKGROUND: It is uncertain whether the association of the intraoperative driving pressure ( P) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average P (...

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Autores:	Mazzinari, G, Neto, AS, Hemmes, SNT, Hedenstierna, G, Jaber, S, Hiesmayr, M, Hollmann, MW, Mills, GH, Melo, MFV, Pearse, RM, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, Cambronero, OD, Ball, L, de Abreu, MG, Pelosi, P, Schultz, MJ, LAS VEGAS Study-Iinvestigators, PROtective VEntilation Network, European Soc Anaesthesiology
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2021
País:	España
Institución:	INCLIVA
Repositorio:	r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:	oai:incliva.fundanetsuite.com:p16150
Acceso en línea:	https://incliva.portalinvestigacion.com/publicaciones/16150
Access Level:	acceso abierto
Palabra clave:	Driving pressure Laparoscopic surgery Laparoscopy PEEP Perioperative ventilation Pneumoperitoneum Protective ventilation Respiratory mechanics

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spelling	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.Mazzinari, GNeto, ASHemmes, SNTHedenstierna, GJaber, SHiesmayr, MHollmann, MWMills, GHMelo, MFVPearse, RMPutensen, CSchmid, WSevergnini, PWrigge, HCambronero, ODBall, Lde Abreu, MGPelosi, PSchultz, MJLAS VEGAS Study-IinvestigatorsPROtective VEntilation NetworkEuropean Soc AnaesthesiologyDriving pressureLaparoscopic surgeryLaparoscopyPEEPPerioperative ventilationPneumoperitoneumProtective ventilationRespiratory mechanicsBACKGROUND: It is uncertain whether the association of the intraoperative driving pressure ( P) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average P ( P(TW)) with PPCs. We also tested the association of P(TW) with intraoperative adverse events. METHODS: Posthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. RESULTS: The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. P was lower in open abdominal surgery patients, but P(TW) was not different between groups. The association of P(TW) with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of P(TW) with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001). CONCLUSIONS: P is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. TRIAL REGISTRATION: LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223 ).BMC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/16150BMC AnesthesiologyISSN: 14712253reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p161502026-06-07T16:35:31Z
dc.title.none.fl_str_mv	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.
title	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.
spellingShingle	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study. Mazzinari, G Driving pressure Laparoscopic surgery Laparoscopy PEEP Perioperative ventilation Pneumoperitoneum Protective ventilation Respiratory mechanics
title_short	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.
title_full	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.
title_fullStr	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.
title_full_unstemmed	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.
title_sort	The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.
dc.creator.none.fl_str_mv	Mazzinari, G Neto, AS Hemmes, SNT Hedenstierna, G Jaber, S Hiesmayr, M Hollmann, MW Mills, GH Melo, MFV Pearse, RM Putensen, C Schmid, W Severgnini, P Wrigge, H Cambronero, OD Ball, L de Abreu, MG Pelosi, P Schultz, MJ LAS VEGAS Study-Iinvestigators PROtective VEntilation Network European Soc Anaesthesiology
author	Mazzinari, G
author_facet	Mazzinari, G Neto, AS Hemmes, SNT Hedenstierna, G Jaber, S Hiesmayr, M Hollmann, MW Mills, GH Melo, MFV Pearse, RM Putensen, C Schmid, W Severgnini, P Wrigge, H Cambronero, OD Ball, L de Abreu, MG Pelosi, P Schultz, MJ LAS VEGAS Study-Iinvestigators PROtective VEntilation Network European Soc Anaesthesiology
author_role	author
author2	Neto, AS Hemmes, SNT Hedenstierna, G Jaber, S Hiesmayr, M Hollmann, MW Mills, GH Melo, MFV Pearse, RM Putensen, C Schmid, W Severgnini, P Wrigge, H Cambronero, OD Ball, L de Abreu, MG Pelosi, P Schultz, MJ LAS VEGAS Study-Iinvestigators PROtective VEntilation Network European Soc Anaesthesiology
author2_role	author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Driving pressure Laparoscopic surgery Laparoscopy PEEP Perioperative ventilation Pneumoperitoneum Protective ventilation Respiratory mechanics
topic	Driving pressure Laparoscopic surgery Laparoscopy PEEP Perioperative ventilation Pneumoperitoneum Protective ventilation Respiratory mechanics
description	BACKGROUND: It is uncertain whether the association of the intraoperative driving pressure ( P) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average P ( P(TW)) with PPCs. We also tested the association of P(TW) with intraoperative adverse events. METHODS: Posthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. RESULTS: The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. P was lower in open abdominal surgery patients, but P(TW) was not different between groups. The association of P(TW) with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of P(TW) with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001). CONCLUSIONS: P is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. TRIAL REGISTRATION: LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223 ).
publishDate	2021
dc.date.none.fl_str_mv	2021
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://incliva.portalinvestigacion.com/publicaciones/16150
url	https://incliva.portalinvestigacion.com/publicaciones/16150
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	BMC
publisher.none.fl_str_mv	BMC
dc.source.none.fl_str_mv	BMC Anesthesiology ISSN: 14712253 reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA instname:INCLIVA
instname_str	INCLIVA
reponame_str	r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection	r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score	15,811543

The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.

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