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Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries. / for the LAS VEGAS study–investigators.

In: BMC anesthesiology, Vol. 22, No. 1, 15, 12.2022.

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@article{6262c16d99544225ba87f4ab9d90e3a0,
title = "Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries",
abstract = "Background: The aim of this analysis is to determine geo–economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods: Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle–income countries (LMIC and UMIC), and high–income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC); secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results: Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0–26.0] in LMIC, 16.0 [3.0–27.0] in UMIC and 15.0 [3.0–26.0] in HIC (P =.003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P <.001). Median tidal volume in ml kg− 1 predicted bodyweight (PBW) was 8.6 [7.7–9.7] in LMIC, 8.4 [7.6–9.5] in UMIC and 8.1 [7.2–9.1] in HIC (P <.001). Median positive end–expiratory pressure in cmH2O was 3.3 [2.0–5.0]) in LMIC, 4.0 [3.0–5.0] in UMIC and 5.0 [3.0–5.0] in HIC (P <.001). Median driving pressure in cmH2O was 14.0 [11.5–18.0] in LMIC, 13.5 [11.0–16.0] in UMIC and 12.0 [10.0–15.0] in HIC (P <.001). Median fraction of inspired oxygen in % was 75 [50–80] in LMIC, 50 [50–63] in UMIC and 53 [45–70] in HIC (P <.001). Intraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P <.001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P =.009). Conclusion: The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC. Trial registration: Clinicaltrials.gov, identifier: NCT01601223.",
keywords = "ARISCAT score, Geo–economic variation, Intraoperative ventilation, Postoperative pulmonary complications, ventilation, intraoperative ventilation, Ventilator management",
author = "{for the LAS VEGAS study–investigators} and Liselotte Hol and Nijbroek, {Sunny G.L.H.} and Neto, {Ary Serpa} and Hemmes, {Sabrine N.T.} and Goran Hedenstierna and Michael Hiesmayr and Hollmann, {Markus W.} and Mills, {Gary H.} and {Vidal Melo}, {Marcos F.} and Christian Putensen and Werner Schmid and Paolo Severgnini and Hermann Wrigge and {de Abreu}, {Marcelo Gama} and Paolo Pelosi and Schultz, {Marcus J.}",
note = "Funding Information: We found small differences in preoperative saturation and intraoperative respiratory rate. These differences reached statistical significance but were probably of no clinical meaning. This interpretation is supported by the between–group comparable median, interquartile ranges, and estimated median differences. Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = dec,
doi = "10.1186/s12871-021-01560-x",
language = "English",
volume = "22",
journal = "BMC anesthesiology",
issn = "1471-2253",
publisher = "BioMed Central",
number = "1",

}

RIS

TY - JOUR

T1 - Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries

AU - for the LAS VEGAS study–investigators

AU - Hol, Liselotte

AU - Nijbroek, Sunny G.L.H.

AU - Neto, Ary Serpa

AU - Hemmes, Sabrine N.T.

AU - Hedenstierna, Goran

AU - Hiesmayr, Michael

AU - Hollmann, Markus W.

AU - Mills, Gary H.

AU - Vidal Melo, Marcos F.

AU - Putensen, Christian

AU - Schmid, Werner

AU - Severgnini, Paolo

AU - Wrigge, Hermann

AU - de Abreu, Marcelo Gama

AU - Pelosi, Paolo

AU - Schultz, Marcus J.

N1 - Funding Information: We found small differences in preoperative saturation and intraoperative respiratory rate. These differences reached statistical significance but were probably of no clinical meaning. This interpretation is supported by the between–group comparable median, interquartile ranges, and estimated median differences. Publisher Copyright: © 2022, The Author(s).

PY - 2022/12

Y1 - 2022/12

N2 - Background: The aim of this analysis is to determine geo–economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods: Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle–income countries (LMIC and UMIC), and high–income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC); secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results: Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0–26.0] in LMIC, 16.0 [3.0–27.0] in UMIC and 15.0 [3.0–26.0] in HIC (P =.003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P <.001). Median tidal volume in ml kg− 1 predicted bodyweight (PBW) was 8.6 [7.7–9.7] in LMIC, 8.4 [7.6–9.5] in UMIC and 8.1 [7.2–9.1] in HIC (P <.001). Median positive end–expiratory pressure in cmH2O was 3.3 [2.0–5.0]) in LMIC, 4.0 [3.0–5.0] in UMIC and 5.0 [3.0–5.0] in HIC (P <.001). Median driving pressure in cmH2O was 14.0 [11.5–18.0] in LMIC, 13.5 [11.0–16.0] in UMIC and 12.0 [10.0–15.0] in HIC (P <.001). Median fraction of inspired oxygen in % was 75 [50–80] in LMIC, 50 [50–63] in UMIC and 53 [45–70] in HIC (P <.001). Intraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P <.001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P =.009). Conclusion: The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC. Trial registration: Clinicaltrials.gov, identifier: NCT01601223.

AB - Background: The aim of this analysis is to determine geo–economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods: Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle–income countries (LMIC and UMIC), and high–income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC); secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results: Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0–26.0] in LMIC, 16.0 [3.0–27.0] in UMIC and 15.0 [3.0–26.0] in HIC (P =.003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P <.001). Median tidal volume in ml kg− 1 predicted bodyweight (PBW) was 8.6 [7.7–9.7] in LMIC, 8.4 [7.6–9.5] in UMIC and 8.1 [7.2–9.1] in HIC (P <.001). Median positive end–expiratory pressure in cmH2O was 3.3 [2.0–5.0]) in LMIC, 4.0 [3.0–5.0] in UMIC and 5.0 [3.0–5.0] in HIC (P <.001). Median driving pressure in cmH2O was 14.0 [11.5–18.0] in LMIC, 13.5 [11.0–16.0] in UMIC and 12.0 [10.0–15.0] in HIC (P <.001). Median fraction of inspired oxygen in % was 75 [50–80] in LMIC, 50 [50–63] in UMIC and 53 [45–70] in HIC (P <.001). Intraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P <.001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P =.009). Conclusion: The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC. Trial registration: Clinicaltrials.gov, identifier: NCT01601223.

KW - ARISCAT score

KW - Geo–economic variation

KW - Intraoperative ventilation

KW - Postoperative pulmonary complications, ventilation, intraoperative ventilation

KW - Ventilator management

UR - http://www.scopus.com/inward/record.url?scp=85122441135&partnerID=8YFLogxK

U2 - 10.1186/s12871-021-01560-x

DO - 10.1186/s12871-021-01560-x

M3 - Article

C2 - 34996361

AN - SCOPUS:85122441135

VL - 22

JO - BMC anesthesiology

JF - BMC anesthesiology

SN - 1471-2253

IS - 1

M1 - 15

ER -

ID: 21928431