Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

LAS VEGAS - An observational study in 29 countries

M.J. Schultz (Corresponding Author), S.N.T. Hemmes, A.S. Neto, J.M. Binnekade, J. Canet, G. Hedenstierna, S. Jaber, M. Hiesmayr, M.W. Hollmann, G.H. Mills, M.F. Vidal Melo, R. Pearse, C. Putensen, W. Schmid, P. Severgnini, H. Wrigge, M.G. De Abreu, P. Pelosi, W. Kroell, H. Metzler & 472 others G. Struber, T. Wegscheider, H. Gombotz, B. Urbanek, B. Leva, S. Damster, B. Plichon, D. Kahn, M. Momeni, A. Pospiech, F. Lois, P. Forget, I. Grosu, J. Poelaert, V. van Mossevelde, M.C. van Malderen, D. Dylst, J. van Melkebeek, M. Beran, S. de Hert, L. De Baerdemaeker, B. Heyse, J. van Limmen, P. Wyffels, T. Jacobs, N. Roels, A. De Bruyne, S. van de Velde, M. Juros-Zovko, D. Djonovic-Omanovic, S. Pernar, J. Zunic, P. Miskovic, A. Zilic, S. Kvolik, D. Ivic, D. Azenic-Venzera, S. Skiljic, H. Vinkovic, I. Oputric, K. Juricic, V. Frkovic, J. Kopic, I. Mirkovic, N. Karanovic, M. Carev, N. Dropulic, J. Pavicic-Ṧaric, G. Erceg, M. Bogdanovic Dvoršcak, B. Mazul-Sunko, A.M. Pavicic, T. Goranovic, B. Maldini, T. Radocaj, Z. Gavranovic, I. Mladic-Batinica, M. Sehovic, P. Stourac, H. Harazim, O. Smekalova, M. Kosinova, T. Kolacek, K. Hudacek, M. Drab, J. Brujevic, K. Vitkova, K. Jirmanova, I. Volfova, P. Dzurnakova, K. Liskova, R. Dudas, R. Filipsky, S. El Kafrawy, H. Hosny Abdelwahab, T. Metwally, A. Abdel-Razek, A.M. El-Shaarawy, W. Fathy Hasan, A. Gouda Ahmed, H. Yassin, M. Magdy, M. Abdelhady, M. Mahran, E. Herodes, P. Kivik, J. Oganjan, A. Aun, A. Sormus, K. Sarapuu, M. Mall, J. Karjagin, E. Futier, A. Petit, A. Gerard, E. Marret, M. Solier, A. Prades, J. Krassler, S. Merzky, C. Uhlig, T. Kiss, A. Bundy, T. Bluth, A. Güldner, P. Spieth, M. Scharffenberg, D. Tran Thiem, T. Koch, T. Treschan, M. Schaefer, B. Bastin, J. Geib, M. Weiss, P. Kienbaum, B. Pannen, A. Gottschalk, M. Konrad, D. Westerheide, B. Schwerdtfeger, P. Simon, A. Reske, C. Nestler, D. Valsamidis, K. Stroumpoulis, G. Antholopoulos, A. Andreou, D. Karapanos, K. Theodoraki, G. Gkiokas, M.K. Tasoulis, T. Sidiropoulou, F. Zafeiropoulou, P. Florou, A. Pandazi, G. Tsaousi, C. Nouris, C. Pourzitaki, D. Bystritski, R. Pizov, A. Eden, C.V. Pesce, A. Campanile, A. Marrella, S. Grasso, M. De Michele, F. Bona, G. Giacoletto, E. Sardo, L. Giancarlo, V. Sottosanti, M. Solca, C.A. Volta, S. Spadaro, M. Verri, R. Ragazzi, R. Zoppellari, G. Cinnella, P. Raimondo, D. La Bella, L. Mirabella, D. D'antini, A. Molin, I. Brunetti, A. Gratarola, G. Pellerano, R. Sileo, S. Pezzatto, L. Montagnani, L. Pasin, G. Landoni, A. Zangrillo, L. Beretta, A.L. Di Parma, V. Tarzia, R. Dossi, M.E. Sassone, D. Sances, S. Tredici, G. Spano, G. Castellani, L. Delunas, S. Peradze, M. Venturino, I. Arpino, S. Sher, C. Tommasino, F. Rapido, P. Morelli, M. Vargas, G. Servillo, A. Cortegiani, S.M. Raineri, F. Montalto, V. Russotto, A. Giarratano, M. Baciarello, M. Generali, G. Cerati, Y. Leykin, F. Bressan, V. Bartolini, L. Zamidei, L. Brazzi, C. Liperi, G. Sales, L. Pistidda, E. Brugnoni, G. Musella, A. Bacuzzi, D. Muhardri, A. Gecaj-Gashi, F. Sada, A. Bytyqi, A. Karbonskiene, R. Aukstakalniene, Z. Teberaite, E. Salciute, R. Tikuisis, P. Miliauskas, S. Jurate, E. Kontrimaviciute, G. Tomkute, J. Xuereb, M. Bezzina, F.J. Borg, I. Wiersma, L. Bos, C. Boer, A. Duvekot, B. In't Veld, A. Werger, P. Dennesen, C. Severijns, J. de Jong, J. Hering, R. van Beek, S. Ivars, I. Jammer, A. Breidablik, K. Skirstad Hodt, F. Fjellanger, M. VicoAvalos, J. Mellin-Olsen, E. Andersson, A. Shafi-Kabiri, R. Molina, S. Wutai, E. Morais, G.R. Tareco, D. Ferreira, J. Amaral, M.L. Gonçalves Castro, S. Cadilha, S. Appleton, S. Parente, M. Correia, D. Martins, A. Monteirosa, A. Ricardo, S. Rodrigues, L. Horhota, I.M. Grintescu, L. Mirea, I.C. Grintescu, D. Corneci, S. Negoita, M. Dutu, I. Popescu Garotescu, D. Filipescu, A.B. Prodan, G. Droc, R. Fota, M. Popescu, D. Tomescu, A.M. Petcu, M.I. Tudoroiu, A. Moise, C.T. Guran, I. Gherghina, D. Costea, I. Cindea, S.M. Copotoiu, R. Copotoiu, V. Barsan, Z. Tolcser, M. Riciu, G.S. Moldovan, M. Veres, A. Gritsan, T. Kapkan, G. Gritsan, O. Korolkov, A. Kulikov, A. Lubnin, A. Ovezov, P. Prokoshev, A. Lugovoy, N. Anipchenko, A. Babayants, I. Komissarova, K. Zalina, V. Likhvantsev, S. Fedorov, A. Lazukic, J. Pejakovic, D. Mihajlovic, Z. Kusnierikova, M. Zelinkova, K. Bruncakova, L. Polakovicova, V. Sobona, B. Novak-Supe, A. Pekle-Golez, M. Jovanov, B. Strazisar, J. Markovic-Bozic, V. Novak-Jankovic, M. Voje, A. Grynyuk, I. Kostadinov, A. Spindler-Vesel, V. Moral, C. Unzueta, C. Puigbo, J. Fava, E. Moret, M.N. Rodriguez Nunez, M. Sendra, A. Brunelli, F. Rodenas, P. Monedero, F. Hidalgo Martinez, M.J. Yepes Temino, A. Marti Nez Simon, A. de Abajo Larriba, A. Lisi, G. Perez, R. Martinez, M. Granell, J. Tatay Vivo, C. Saiz Ruiz, J.A. de Andre S Iban Ez, E. Pastor, M. Soro, C. Ferrando, M. Defez, C. Aldecoa Alvares-Santullano, R. Pere, J. Rico, M. Jawad, Y. Saeed, L. Gillberg, Z. Kazak Bengisun, B. Kansu Kazbek, N. Coskunfirat, N. Boztug, S. Sanli, M. Yilmaz, N. Hadimioglu, N.M. Senturk, E. Camci, S. Kucukgoncu, Z. Sungur, N. Sivrikoz, S. Ustalar Ozgen, F. Toraman, O. Selvi, O. Senturk, M. Yildiz, B. Kuvaki, F. Gunenc, S. Kucukguclu, S.U. Ozbilgin, J. Maral, S. Canli, O. Arun, A. Saltali, E. Aydogan, F.N. Akgün, C. Sanlikarip, F. Mine Karaman, A. Mazur, S. Vorotyntsev, G. Rousseau, C. Barrett, L. Stancombe, B. Shelley, H. Scholes, J. Limb, A. Rafi, L. Wayman, J. Deane, D. Rogerson, J. Williams, S. Yates, E. Rogers, M. Pulletz, S. Moreton, S. Jones, S. Venkatesh, M. Burton, L. Brown, C. Goodall, M. Rucklidge, D. Fuller, M. Nadolski, S. Kusre, M. Lundberg, L. Everett, H. Nutt, M. Zuleika, P. Carvalho, D. Clements, B. Creagh-Brown, P. Watt, P. Raymode, O. Mohr, A. Raj, T. Creary, A. Chishti, A. Bell, C. Higham, A. Cain, S. Gibb, S. Mowat, D. Franklin, C. West, G. Minto, N. Boyd, E. Calton, R. Walker, F. Mackenzie, B. Ellison, H. Roberts, M. Chikungwa, C. Jackson, A. Donovan, J. Foot, E. Homan, J. Montgomery, D. Portch, P. Mercer, J. Palmer, J. Paddle, A. Fouracres, A. Datson, A. Andrew, L. Welch, A. Rose, S. Varma, K. Simeson, M. Rambhatla, J. Susarla, S. Marri, K. Kodaganallur, A. Das, S. Algarsamy, J. Colley, S. Davies, M. Szewczyk, T. Smith, A. Fernandez-Bustamante, E. Luzier, A. Almagro, L. Fernando, D. Sulemanji, J. Sprung, T. Weingarten, D. Kor, F. Scavonetto, Y. Tze

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.
Original languageEnglish
Pages (from-to)492–507
Number of pages16
JournalEuropean journal of anaesthesiology
Volume34
Issue number8
Early online date14 Jun 2017
DOIs
Publication statusPublished - Aug 2017

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Observational Studies
Ventilation
Epidemiology
Lung
Positive-Pressure Respiration
Incidence
Tidal Volume
General Anesthesia
Length of Stay

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Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications : LAS VEGAS - An observational study in 29 countries. / Schultz, M.J. (Corresponding Author); Hemmes, S.N.T.; Neto, A.S.; Binnekade, J.M.; Canet, J.; Hedenstierna, G.; Jaber, S.; Hiesmayr, M.; Hollmann, M.W.; Mills, G.H.; Vidal Melo, M.F.; Pearse, R.; Putensen, C.; Schmid, W.; Severgnini, P.; Wrigge, H.; De Abreu, M.G.; Pelosi, P.; Kroell, W.; Metzler, H.; Struber, G.; Wegscheider, T.; Gombotz, H.; Urbanek, B.; Leva, B.; Damster, S.; Plichon, B.; Kahn, D.; Momeni, M.; Pospiech, A.; Lois, F.; Forget, P.; Grosu, I.; Poelaert, J.; van Mossevelde, V.; van Malderen, M.C.; Dylst, D.; van Melkebeek, J.; Beran, M.; de Hert, S.; De Baerdemaeker, L.; Heyse, B.; van Limmen, J.; Wyffels, P.; Jacobs, T.; Roels, N.; De Bruyne, A.; van de Velde, S.; Juros-Zovko, M.; Djonovic-Omanovic, D.; Pernar, S.; Zunic, J.; Miskovic, P.; Zilic, A.; Kvolik, S.; Ivic, D.; Azenic-Venzera, D.; Skiljic, S.; Vinkovic, H.; Oputric, I.; Juricic, K.; Frkovic, V.; Kopic, J.; Mirkovic, I.; Karanovic, N.; Carev, M.; Dropulic, N.; Pavicic-Ṧaric, J.; Erceg, G.; Bogdanovic Dvoršcak, M.; Mazul-Sunko, B.; Pavicic, A.M.; Goranovic, T.; Maldini, B.; Radocaj, T.; Gavranovic, Z.; Mladic-Batinica, I.; Sehovic, M.; Stourac, P.; Harazim, H.; Smekalova, O.; Kosinova, M.; Kolacek, T.; Hudacek, K.; Drab, M.; Brujevic, J.; Vitkova, K.; Jirmanova, K.; Volfova, I.; Dzurnakova, P.; Liskova, K.; Dudas, R.; Filipsky, R.; El Kafrawy, S.; Hosny Abdelwahab, H.; Metwally, T.; Abdel-Razek, A.; El-Shaarawy, A.M.; Fathy Hasan, W.; Gouda Ahmed, A.; Yassin, H.; Magdy, M.; Abdelhady, M.; Mahran, M.; Herodes, E.; Kivik, P.; Oganjan, J.; Aun, A.; Sormus, A.; Sarapuu, K.; Mall, M.; Karjagin, J.; Futier, E.; Petit, A.; Gerard, A.; Marret, E.; Solier, M.; Prades, A.; Krassler, J.; Merzky, S.; Uhlig, C.; Kiss, T.; Bundy, A.; Bluth, T.; Güldner, A.; Spieth, P.; Scharffenberg, M.; Tran Thiem, D.; Koch, T.; Treschan, T.; Schaefer, M.; Bastin, B.; Geib, J.; Weiss, M.; Kienbaum, P.; Pannen, B.; Gottschalk, A.; Konrad, M.; Westerheide, D.; Schwerdtfeger, B.; Simon, P.; Reske, A.; Nestler, C.; Valsamidis, D.; Stroumpoulis, K.; Antholopoulos, G.; Andreou, A.; Karapanos, D.; Theodoraki, K.; Gkiokas, G.; Tasoulis, M.K.; Sidiropoulou, T.; Zafeiropoulou, F.; Florou, P.; Pandazi, A.; Tsaousi, G.; Nouris, C.; Pourzitaki, C.; Bystritski, D.; Pizov, R.; Eden, A.; Pesce, C.V.; Campanile, A.; Marrella, A.; Grasso, S.; De Michele, M.; Bona, F.; Giacoletto, G.; Sardo, E.; Giancarlo, L.; Sottosanti, V.; Solca, M.; Volta, C.A.; Spadaro, S.; Verri, M.; Ragazzi, R.; Zoppellari, R.; Cinnella, G.; Raimondo, P.; La Bella, D.; Mirabella, L.; D'antini, D.; Molin, A.; Brunetti, I.; Gratarola, A.; Pellerano, G.; Sileo, R.; Pezzatto, S.; Montagnani, L.; Pasin, L.; Landoni, G.; Zangrillo, A.; Beretta, L.; Di Parma, A.L.; Tarzia, V.; Dossi, R.; Sassone, M.E.; Sances, D.; Tredici, S.; Spano, G.; Castellani, G.; Delunas, L.; Peradze, S.; Venturino, M.; Arpino, I.; Sher, S.; Tommasino, C.; Rapido, F.; Morelli, P.; Vargas, M.; Servillo, G.; Cortegiani, A.; Raineri, S.M.; Montalto, F.; Russotto, V.; Giarratano, A.; Baciarello, M.; Generali, M.; Cerati, G.; Leykin, Y.; Bressan, F.; Bartolini, V.; Zamidei, L.; Brazzi, L.; Liperi, C.; Sales, G.; Pistidda, L.; Brugnoni, E.; Musella, G.; Bacuzzi, A.; Muhardri, D.; Gecaj-Gashi, A.; Sada, F.; Bytyqi, A.; Karbonskiene, A.; Aukstakalniene, R.; Teberaite, Z.; Salciute, E.; Tikuisis, R.; Miliauskas, P.; Jurate, S.; Kontrimaviciute, E.; Tomkute, G.; Xuereb, J.; Bezzina, M.; Borg, F.J.; Wiersma, I.; Bos, L.; Boer, C.; Duvekot, A.; In't Veld, B.; Werger, A.; Dennesen, P.; Severijns, C.; de Jong, J.; Hering, J.; van Beek, R.; Ivars, S.; Jammer, I.; Breidablik, A.; Skirstad Hodt, K.; Fjellanger, F.; VicoAvalos, M.; Mellin-Olsen, J.; Andersson, E.; Shafi-Kabiri, A.; Molina, R.; Wutai, S.; Morais, E.; Tareco, G.R.; Ferreira, D.; Amaral, J.; Gonçalves Castro, M.L.; Cadilha, S.; Appleton, S.; Parente, S.; Correia, M.; Martins, D.; Monteirosa, A.; Ricardo, A.; Rodrigues, S.; Horhota, L.; Grintescu, I.M.; Mirea, L.; Grintescu, I.C.; Corneci, D.; Negoita, S.; Dutu, M.; Popescu Garotescu, I.; Filipescu, D.; Prodan, A.B.; Droc, G.; Fota, R.; Popescu, M.; Tomescu, D.; Petcu, A.M.; Tudoroiu, M.I.; Moise, A.; Guran, C.T.; Gherghina, I.; Costea, D.; Cindea, I.; Copotoiu, S.M.; Copotoiu, R.; Barsan, V.; Tolcser, Z.; Riciu, M.; Moldovan, G.S.; Veres, M.; Gritsan, A.; Kapkan, T.; Gritsan, G.; Korolkov, O.; Kulikov, A.; Lubnin, A.; Ovezov, A.; Prokoshev, P.; Lugovoy, A.; Anipchenko, N.; Babayants, A.; Komissarova, I.; Zalina, K.; Likhvantsev, V.; Fedorov, S.; Lazukic, A.; Pejakovic, J.; Mihajlovic, D.; Kusnierikova, Z.; Zelinkova, M.; Bruncakova, K.; Polakovicova, L.; Sobona, V.; Novak-Supe, B.; Pekle-Golez, A.; Jovanov, M.; Strazisar, B.; Markovic-Bozic, J.; Novak-Jankovic, V.; Voje, M.; Grynyuk, A.; Kostadinov, I.; Spindler-Vesel, A.; Moral, V.; Unzueta, C.; Puigbo, C.; Fava, J.; Moret, E.; Rodriguez Nunez, M.N.; Sendra, M.; Brunelli, A.; Rodenas, F.; Monedero, P.; Hidalgo Martinez, F.; Yepes Temino, M.J.; Marti Nez Simon, A.; de Abajo Larriba, A.; Lisi, A.; Perez, G.; Martinez, R.; Granell, M.; Tatay Vivo, J.; Saiz Ruiz, C.; de Andre S Iban Ez, J.A.; Pastor, E.; Soro, M.; Ferrando, C.; Defez, M.; Aldecoa Alvares-Santullano, C.; Pere, R.; Rico, J.; Jawad, M.; Saeed, Y.; Gillberg, L.; Kazak Bengisun, Z.; Kansu Kazbek, B.; Coskunfirat, N.; Boztug, N.; Sanli, S.; Yilmaz, M.; Hadimioglu, N.; Senturk, N.M.; Camci, E.; Kucukgoncu, S.; Sungur, Z.; Sivrikoz, N.; Ustalar Ozgen, S.; Toraman, F.; Selvi, O.; Senturk, O.; Yildiz, M.; Kuvaki, B.; Gunenc, F.; Kucukguclu, S.; Ozbilgin, S.U.; Maral, J.; Canli, S.; Arun, O.; Saltali, A.; Aydogan, E.; Akgün, F.N.; Sanlikarip, C.; Mine Karaman, F.; Mazur, A.; Vorotyntsev, S.; Rousseau, G.; Barrett, C.; Stancombe, L.; Shelley, B.; Scholes, H.; Limb, J.; Rafi, A.; Wayman, L.; Deane, J.; Rogerson, D.; Williams, J.; Yates, S.; Rogers, E.; Pulletz, M.; Moreton, S.; Jones, S.; Venkatesh, S.; Burton, M.; Brown, L.; Goodall, C.; Rucklidge, M.; Fuller, D.; Nadolski, M.; Kusre, S.; Lundberg, M.; Everett, L.; Nutt, H.; Zuleika, M.; Carvalho, P.; Clements, D.; Creagh-Brown, B.; Watt, P.; Raymode, P.; Mohr, O.; Raj, A.; Creary, T.; Chishti, A.; Bell, A.; Higham, C.; Cain, A.; Gibb, S.; Mowat, S.; Franklin, D.; West, C.; Minto, G.; Boyd, N.; Calton, E.; Walker, R.; Mackenzie, F.; Ellison, B.; Roberts, H.; Chikungwa, M.; Jackson, C.; Donovan, A.; Foot, J.; Homan, E.; Montgomery, J.; Portch, D.; Mercer, P.; Palmer, J.; Paddle, J.; Fouracres, A.; Datson, A.; Andrew, A.; Welch, L.; Rose, A.; Varma, S.; Simeson, K.; Rambhatla, M.; Susarla, J.; Marri, S.; Kodaganallur, K.; Das, A.; Algarsamy, S.; Colley, J.; Davies, S.; Szewczyk, M.; Smith, T.; Fernandez-Bustamante, A.; Luzier, E.; Almagro, A.; Fernando, L.; Sulemanji, D.; Sprung, J.; Weingarten, T.; Kor, D.; Scavonetto, F.; Tze, Y.

In: European journal of anaesthesiology, Vol. 34, No. 8, 08.2017, p. 492–507.

Research output: Contribution to journalArticle

Schultz, MJ, Hemmes, SNT, Neto, AS, Binnekade, JM, Canet, J, Hedenstierna, G, Jaber, S, Hiesmayr, M, Hollmann, MW, Mills, GH, Vidal Melo, MF, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, De Abreu, MG, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Leva, B, Damster, S, Plichon, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, van Mossevelde, V, van Malderen, MC, Dylst, D, van Melkebeek, J, Beran, M, de Hert, S, De Baerdemaeker, L, Heyse, B, van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, van de Velde, S, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Pavicic-Ṧaric, J, Erceg, G, Bogdanovic Dvoršcak, M, Mazul-Sunko, B, Pavicic, AM, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Hosny Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, AM, Fathy Hasan, W, Gouda Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Güldner, A, Spieth, P, Scharffenberg, M, Tran Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, MK, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, CV, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, CA, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, AL, Tarzia, V, Dossi, R, Sassone, ME, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, SM, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, FJ, Wiersma, I, Bos, L, Boer, C, Duvekot, A, In't Veld, B, Werger, A, Dennesen, P, Severijns, C, de Jong, J, Hering, J, van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Skirstad Hodt, K, Fjellanger, F, VicoAvalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, GR, Ferreira, D, Amaral, J, Gonçalves Castro, ML, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, IM, Mirea, L, Grintescu, IC, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, AB, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, AM, Tudoroiu, MI, Moise, A, Guran, CT, Gherghina, I, Costea, D, Cindea, I, Copotoiu, SM, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, GS, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, C, Puigbo, C, Fava, J, Moret, E, Rodriguez Nunez, MN, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Hidalgo Martinez, F, Yepes Temino, MJ, Marti Nez Simon, A, de Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Tatay Vivo, J, Saiz Ruiz, C, de Andre S Iban Ez, JA, Pastor, E, Soro, M, Ferrando, C, Defez, M, Aldecoa Alvares-Santullano, C, Pere, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Kazak Bengisun, Z, Kansu Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, NM, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ustalar Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, SU, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgün, FN, Sanlikarip, C, Mine Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F & Tze, Y 2017, 'Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries', European journal of anaesthesiology, vol. 34, no. 8, pp. 492–507. https://doi.org/10.1097/EJA.0000000000000646
Schultz, M.J. ; Hemmes, S.N.T. ; Neto, A.S. ; Binnekade, J.M. ; Canet, J. ; Hedenstierna, G. ; Jaber, S. ; Hiesmayr, M. ; Hollmann, M.W. ; Mills, G.H. ; Vidal Melo, M.F. ; Pearse, R. ; Putensen, C. ; Schmid, W. ; Severgnini, P. ; Wrigge, H. ; De Abreu, M.G. ; Pelosi, P. ; Kroell, W. ; Metzler, H. ; Struber, G. ; Wegscheider, T. ; Gombotz, H. ; Urbanek, B. ; Leva, B. ; Damster, S. ; Plichon, B. ; Kahn, D. ; Momeni, M. ; Pospiech, A. ; Lois, F. ; Forget, P. ; Grosu, I. ; Poelaert, J. ; van Mossevelde, V. ; van Malderen, M.C. ; Dylst, D. ; van Melkebeek, J. ; Beran, M. ; de Hert, S. ; De Baerdemaeker, L. ; Heyse, B. ; van Limmen, J. ; Wyffels, P. ; Jacobs, T. ; Roels, N. ; De Bruyne, A. ; van de Velde, S. ; Juros-Zovko, M. ; Djonovic-Omanovic, D. ; Pernar, S. ; Zunic, J. ; Miskovic, P. ; Zilic, A. ; Kvolik, S. ; Ivic, D. ; Azenic-Venzera, D. ; Skiljic, S. ; Vinkovic, H. ; Oputric, I. ; Juricic, K. ; Frkovic, V. ; Kopic, J. ; Mirkovic, I. ; Karanovic, N. ; Carev, M. ; Dropulic, N. ; Pavicic-Ṧaric, J. ; Erceg, G. ; Bogdanovic Dvoršcak, M. ; Mazul-Sunko, B. ; Pavicic, A.M. ; Goranovic, T. ; Maldini, B. ; Radocaj, T. ; Gavranovic, Z. ; Mladic-Batinica, I. ; Sehovic, M. ; Stourac, P. ; Harazim, H. ; Smekalova, O. ; Kosinova, M. ; Kolacek, T. ; Hudacek, K. ; Drab, M. ; Brujevic, J. ; Vitkova, K. ; Jirmanova, K. ; Volfova, I. ; Dzurnakova, P. ; Liskova, K. ; Dudas, R. ; Filipsky, R. ; El Kafrawy, S. ; Hosny Abdelwahab, H. ; Metwally, T. ; Abdel-Razek, A. ; El-Shaarawy, A.M. ; Fathy Hasan, W. ; Gouda Ahmed, A. ; Yassin, H. ; Magdy, M. ; Abdelhady, M. ; Mahran, M. ; Herodes, E. ; Kivik, P. ; Oganjan, J. ; Aun, A. ; Sormus, A. ; Sarapuu, K. ; Mall, M. ; Karjagin, J. ; Futier, E. ; Petit, A. ; Gerard, A. ; Marret, E. ; Solier, M. ; Prades, A. ; Krassler, J. ; Merzky, S. ; Uhlig, C. ; Kiss, T. ; Bundy, A. ; Bluth, T. ; Güldner, A. ; Spieth, P. ; Scharffenberg, M. ; Tran Thiem, D. ; Koch, T. ; Treschan, T. ; Schaefer, M. ; Bastin, B. ; Geib, J. ; Weiss, M. ; Kienbaum, P. ; Pannen, B. ; Gottschalk, A. ; Konrad, M. ; Westerheide, D. ; Schwerdtfeger, B. ; Simon, P. ; Reske, A. ; Nestler, C. ; Valsamidis, D. ; Stroumpoulis, K. ; Antholopoulos, G. ; Andreou, A. ; Karapanos, D. ; Theodoraki, K. ; Gkiokas, G. ; Tasoulis, M.K. ; Sidiropoulou, T. ; Zafeiropoulou, F. ; Florou, P. ; Pandazi, A. ; Tsaousi, G. ; Nouris, C. ; Pourzitaki, C. ; Bystritski, D. ; Pizov, R. ; Eden, A. ; Pesce, C.V. ; Campanile, A. ; Marrella, A. ; Grasso, S. ; De Michele, M. ; Bona, F. ; Giacoletto, G. ; Sardo, E. ; Giancarlo, L. ; Sottosanti, V. ; Solca, M. ; Volta, C.A. ; Spadaro, S. ; Verri, M. ; Ragazzi, R. ; Zoppellari, R. ; Cinnella, G. ; Raimondo, P. ; La Bella, D. ; Mirabella, L. ; D'antini, D. ; Molin, A. ; Brunetti, I. ; Gratarola, A. ; Pellerano, G. ; Sileo, R. ; Pezzatto, S. ; Montagnani, L. ; Pasin, L. ; Landoni, G. ; Zangrillo, A. ; Beretta, L. ; Di Parma, A.L. ; Tarzia, V. ; Dossi, R. ; Sassone, M.E. ; Sances, D. ; Tredici, S. ; Spano, G. ; Castellani, G. ; Delunas, L. ; Peradze, S. ; Venturino, M. ; Arpino, I. ; Sher, S. ; Tommasino, C. ; Rapido, F. ; Morelli, P. ; Vargas, M. ; Servillo, G. ; Cortegiani, A. ; Raineri, S.M. ; Montalto, F. ; Russotto, V. ; Giarratano, A. ; Baciarello, M. ; Generali, M. ; Cerati, G. ; Leykin, Y. ; Bressan, F. ; Bartolini, V. ; Zamidei, L. ; Brazzi, L. ; Liperi, C. ; Sales, G. ; Pistidda, L. ; Brugnoni, E. ; Musella, G. ; Bacuzzi, A. ; Muhardri, D. ; Gecaj-Gashi, A. ; Sada, F. ; Bytyqi, A. ; Karbonskiene, A. ; Aukstakalniene, R. ; Teberaite, Z. ; Salciute, E. ; Tikuisis, R. ; Miliauskas, P. ; Jurate, S. ; Kontrimaviciute, E. ; Tomkute, G. ; Xuereb, J. ; Bezzina, M. ; Borg, F.J. ; Wiersma, I. ; Bos, L. ; Boer, C. ; Duvekot, A. ; In't Veld, B. ; Werger, A. ; Dennesen, P. ; Severijns, C. ; de Jong, J. ; Hering, J. ; van Beek, R. ; Ivars, S. ; Jammer, I. ; Breidablik, A. ; Skirstad Hodt, K. ; Fjellanger, F. ; VicoAvalos, M. ; Mellin-Olsen, J. ; Andersson, E. ; Shafi-Kabiri, A. ; Molina, R. ; Wutai, S. ; Morais, E. ; Tareco, G.R. ; Ferreira, D. ; Amaral, J. ; Gonçalves Castro, M.L. ; Cadilha, S. ; Appleton, S. ; Parente, S. ; Correia, M. ; Martins, D. ; Monteirosa, A. ; Ricardo, A. ; Rodrigues, S. ; Horhota, L. ; Grintescu, I.M. ; Mirea, L. ; Grintescu, I.C. ; Corneci, D. ; Negoita, S. ; Dutu, M. ; Popescu Garotescu, I. ; Filipescu, D. ; Prodan, A.B. ; Droc, G. ; Fota, R. ; Popescu, M. ; Tomescu, D. ; Petcu, A.M. ; Tudoroiu, M.I. ; Moise, A. ; Guran, C.T. ; Gherghina, I. ; Costea, D. ; Cindea, I. ; Copotoiu, S.M. ; Copotoiu, R. ; Barsan, V. ; Tolcser, Z. ; Riciu, M. ; Moldovan, G.S. ; Veres, M. ; Gritsan, A. ; Kapkan, T. ; Gritsan, G. ; Korolkov, O. ; Kulikov, A. ; Lubnin, A. ; Ovezov, A. ; Prokoshev, P. ; Lugovoy, A. ; Anipchenko, N. ; Babayants, A. ; Komissarova, I. ; Zalina, K. ; Likhvantsev, V. ; Fedorov, S. ; Lazukic, A. ; Pejakovic, J. ; Mihajlovic, D. ; Kusnierikova, Z. ; Zelinkova, M. ; Bruncakova, K. ; Polakovicova, L. ; Sobona, V. ; Novak-Supe, B. ; Pekle-Golez, A. ; Jovanov, M. ; Strazisar, B. ; Markovic-Bozic, J. ; Novak-Jankovic, V. ; Voje, M. ; Grynyuk, A. ; Kostadinov, I. ; Spindler-Vesel, A. ; Moral, V. ; Unzueta, C. ; Puigbo, C. ; Fava, J. ; Moret, E. ; Rodriguez Nunez, M.N. ; Sendra, M. ; Brunelli, A. ; Rodenas, F. ; Monedero, P. ; Hidalgo Martinez, F. ; Yepes Temino, M.J. ; Marti Nez Simon, A. ; de Abajo Larriba, A. ; Lisi, A. ; Perez, G. ; Martinez, R. ; Granell, M. ; Tatay Vivo, J. ; Saiz Ruiz, C. ; de Andre S Iban Ez, J.A. ; Pastor, E. ; Soro, M. ; Ferrando, C. ; Defez, M. ; Aldecoa Alvares-Santullano, C. ; Pere, R. ; Rico, J. ; Jawad, M. ; Saeed, Y. ; Gillberg, L. ; Kazak Bengisun, Z. ; Kansu Kazbek, B. ; Coskunfirat, N. ; Boztug, N. ; Sanli, S. ; Yilmaz, M. ; Hadimioglu, N. ; Senturk, N.M. ; Camci, E. ; Kucukgoncu, S. ; Sungur, Z. ; Sivrikoz, N. ; Ustalar Ozgen, S. ; Toraman, F. ; Selvi, O. ; Senturk, O. ; Yildiz, M. ; Kuvaki, B. ; Gunenc, F. ; Kucukguclu, S. ; Ozbilgin, S.U. ; Maral, J. ; Canli, S. ; Arun, O. ; Saltali, A. ; Aydogan, E. ; Akgün, F.N. ; Sanlikarip, C. ; Mine Karaman, F. ; Mazur, A. ; Vorotyntsev, S. ; Rousseau, G. ; Barrett, C. ; Stancombe, L. ; Shelley, B. ; Scholes, H. ; Limb, J. ; Rafi, A. ; Wayman, L. ; Deane, J. ; Rogerson, D. ; Williams, J. ; Yates, S. ; Rogers, E. ; Pulletz, M. ; Moreton, S. ; Jones, S. ; Venkatesh, S. ; Burton, M. ; Brown, L. ; Goodall, C. ; Rucklidge, M. ; Fuller, D. ; Nadolski, M. ; Kusre, S. ; Lundberg, M. ; Everett, L. ; Nutt, H. ; Zuleika, M. ; Carvalho, P. ; Clements, D. ; Creagh-Brown, B. ; Watt, P. ; Raymode, P. ; Mohr, O. ; Raj, A. ; Creary, T. ; Chishti, A. ; Bell, A. ; Higham, C. ; Cain, A. ; Gibb, S. ; Mowat, S. ; Franklin, D. ; West, C. ; Minto, G. ; Boyd, N. ; Calton, E. ; Walker, R. ; Mackenzie, F. ; Ellison, B. ; Roberts, H. ; Chikungwa, M. ; Jackson, C. ; Donovan, A. ; Foot, J. ; Homan, E. ; Montgomery, J. ; Portch, D. ; Mercer, P. ; Palmer, J. ; Paddle, J. ; Fouracres, A. ; Datson, A. ; Andrew, A. ; Welch, L. ; Rose, A. ; Varma, S. ; Simeson, K. ; Rambhatla, M. ; Susarla, J. ; Marri, S. ; Kodaganallur, K. ; Das, A. ; Algarsamy, S. ; Colley, J. ; Davies, S. ; Szewczyk, M. ; Smith, T. ; Fernandez-Bustamante, A. ; Luzier, E. ; Almagro, A. ; Fernando, L. ; Sulemanji, D. ; Sprung, J. ; Weingarten, T. ; Kor, D. ; Scavonetto, F. ; Tze, Y. / Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications : LAS VEGAS - An observational study in 29 countries. In: European journal of anaesthesiology. 2017 ; Vol. 34, No. 8. pp. 492–507.
@article{a37e7b4a6ad24d65bdbb1a7b67fcc1aa,
title = "Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries",
abstract = "BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4{\%}. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3{\%} receiving more than 5 cmH2O PEEP compared with 7.6{\%} in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7{\%}, relative risk (RR) 3.16 (95{\%} confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.",
author = "M.J. Schultz and S.N.T. Hemmes and A.S. Neto and J.M. Binnekade and J. Canet and G. Hedenstierna and S. Jaber and M. Hiesmayr and M.W. Hollmann and G.H. Mills and {Vidal Melo}, M.F. and R. Pearse and C. Putensen and W. Schmid and P. Severgnini and H. Wrigge and {De Abreu}, M.G. and P. Pelosi and W. Kroell and H. Metzler and G. Struber and T. Wegscheider and H. Gombotz and B. Urbanek and B. Leva and S. Damster and B. Plichon and D. Kahn and M. Momeni and A. Pospiech and F. Lois and P. Forget and I. Grosu and J. Poelaert and {van Mossevelde}, V. and {van Malderen}, M.C. and D. Dylst and {van Melkebeek}, J. and M. Beran and {de Hert}, S. and {De Baerdemaeker}, L. and B. Heyse and {van Limmen}, J. and P. Wyffels and T. Jacobs and N. Roels and {De Bruyne}, A. and {van de Velde}, S. and M. Juros-Zovko and D. Djonovic-Omanovic and S. Pernar and J. Zunic and P. Miskovic and A. Zilic and S. Kvolik and D. Ivic and D. Azenic-Venzera and S. Skiljic and H. Vinkovic and I. Oputric and K. Juricic and V. Frkovic and J. Kopic and I. Mirkovic and N. Karanovic and M. Carev and N. Dropulic and J. Pavicic-Ṧaric and G. Erceg and {Bogdanovic Dvoršcak}, M. and B. Mazul-Sunko and A.M. Pavicic and T. Goranovic and B. Maldini and T. Radocaj and Z. Gavranovic and I. Mladic-Batinica and M. Sehovic and P. Stourac and H. Harazim and O. Smekalova and M. Kosinova and T. Kolacek and K. Hudacek and M. Drab and J. Brujevic and K. Vitkova and K. Jirmanova and I. Volfova and P. Dzurnakova and K. Liskova and R. Dudas and R. Filipsky and {El Kafrawy}, S. and {Hosny Abdelwahab}, H. and T. Metwally and A. Abdel-Razek and A.M. El-Shaarawy and {Fathy Hasan}, W. and {Gouda Ahmed}, A. and H. Yassin and M. Magdy and M. Abdelhady and M. Mahran and E. Herodes and P. Kivik and J. Oganjan and A. Aun and A. Sormus and K. Sarapuu and M. Mall and J. Karjagin and E. Futier and A. Petit and A. Gerard and E. Marret and M. Solier and A. Prades and J. Krassler and S. Merzky and C. Uhlig and T. Kiss and A. Bundy and T. Bluth and A. G{\"u}ldner and P. Spieth and M. Scharffenberg and {Tran Thiem}, D. and T. Koch and T. Treschan and M. Schaefer and B. Bastin and J. Geib and M. Weiss and P. Kienbaum and B. Pannen and A. Gottschalk and M. Konrad and D. Westerheide and B. Schwerdtfeger and P. Simon and A. Reske and C. Nestler and D. Valsamidis and K. Stroumpoulis and G. Antholopoulos and A. Andreou and D. Karapanos and K. Theodoraki and G. Gkiokas and M.K. Tasoulis and T. Sidiropoulou and F. Zafeiropoulou and P. Florou and A. Pandazi and G. Tsaousi and C. Nouris and C. Pourzitaki and D. Bystritski and R. Pizov and A. Eden and C.V. Pesce and A. Campanile and A. Marrella and S. Grasso and {De Michele}, M. and F. Bona and G. Giacoletto and E. Sardo and L. Giancarlo and V. Sottosanti and M. Solca and C.A. Volta and S. Spadaro and M. Verri and R. Ragazzi and R. Zoppellari and G. Cinnella and P. Raimondo and {La Bella}, D. and L. Mirabella and D. D'antini and A. Molin and I. Brunetti and A. Gratarola and G. Pellerano and R. Sileo and S. Pezzatto and L. Montagnani and L. Pasin and G. Landoni and A. Zangrillo and L. Beretta and {Di Parma}, A.L. and V. Tarzia and R. Dossi and M.E. Sassone and D. Sances and S. Tredici and G. Spano and G. Castellani and L. Delunas and S. Peradze and M. Venturino and I. Arpino and S. Sher and C. Tommasino and F. Rapido and P. Morelli and M. Vargas and G. Servillo and A. Cortegiani and S.M. Raineri and F. Montalto and V. Russotto and A. Giarratano and M. Baciarello and M. Generali and G. Cerati and Y. Leykin and F. Bressan and V. Bartolini and L. Zamidei and L. Brazzi and C. Liperi and G. Sales and L. Pistidda and E. Brugnoni and G. Musella and A. Bacuzzi and D. Muhardri and A. Gecaj-Gashi and F. Sada and A. Bytyqi and A. Karbonskiene and R. Aukstakalniene and Z. Teberaite and E. Salciute and R. Tikuisis and P. Miliauskas and S. Jurate and E. Kontrimaviciute and G. Tomkute and J. Xuereb and M. Bezzina and F.J. Borg and I. Wiersma and L. Bos and C. Boer and A. Duvekot and {In't Veld}, B. and A. Werger and P. Dennesen and C. Severijns and {de Jong}, J. and J. Hering and {van Beek}, R. and S. Ivars and I. Jammer and A. Breidablik and {Skirstad Hodt}, K. and F. Fjellanger and M. VicoAvalos and J. Mellin-Olsen and E. Andersson and A. Shafi-Kabiri and R. Molina and S. Wutai and E. Morais and G.R. Tareco and D. Ferreira and J. Amaral and {Gon{\cc}alves Castro}, M.L. and S. Cadilha and S. Appleton and S. Parente and M. Correia and D. Martins and A. Monteirosa and A. Ricardo and S. Rodrigues and L. Horhota and I.M. Grintescu and L. Mirea and I.C. Grintescu and D. Corneci and S. Negoita and M. Dutu and {Popescu Garotescu}, I. and D. Filipescu and A.B. Prodan and G. Droc and R. Fota and M. Popescu and D. Tomescu and A.M. Petcu and M.I. Tudoroiu and A. Moise and C.T. Guran and I. Gherghina and D. Costea and I. Cindea and S.M. Copotoiu and R. Copotoiu and V. Barsan and Z. Tolcser and M. Riciu and G.S. Moldovan and M. Veres and A. Gritsan and T. Kapkan and G. Gritsan and O. Korolkov and A. Kulikov and A. Lubnin and A. Ovezov and P. Prokoshev and A. Lugovoy and N. Anipchenko and A. Babayants and I. Komissarova and K. Zalina and V. Likhvantsev and S. Fedorov and A. Lazukic and J. Pejakovic and D. Mihajlovic and Z. Kusnierikova and M. Zelinkova and K. Bruncakova and L. Polakovicova and V. Sobona and B. Novak-Supe and A. Pekle-Golez and M. Jovanov and B. Strazisar and J. Markovic-Bozic and V. Novak-Jankovic and M. Voje and A. Grynyuk and I. Kostadinov and A. Spindler-Vesel and V. Moral and C. Unzueta and C. Puigbo and J. Fava and E. Moret and {Rodriguez Nunez}, M.N. and M. Sendra and A. Brunelli and F. Rodenas and P. Monedero and {Hidalgo Martinez}, F. and {Yepes Temino}, M.J. and {Marti Nez Simon}, A. and {de Abajo Larriba}, A. and A. Lisi and G. Perez and R. Martinez and M. Granell and {Tatay Vivo}, J. and {Saiz Ruiz}, C. and {de Andre S Iban Ez}, J.A. and E. Pastor and M. Soro and C. Ferrando and M. Defez and {Aldecoa Alvares-Santullano}, C. and R. Pere and J. Rico and M. Jawad and Y. Saeed and L. Gillberg and {Kazak Bengisun}, Z. and {Kansu Kazbek}, B. and N. Coskunfirat and N. Boztug and S. Sanli and M. Yilmaz and N. Hadimioglu and N.M. Senturk and E. Camci and S. Kucukgoncu and Z. Sungur and N. Sivrikoz and {Ustalar Ozgen}, S. and F. Toraman and O. Selvi and O. Senturk and M. Yildiz and B. Kuvaki and F. Gunenc and S. Kucukguclu and S.U. Ozbilgin and J. Maral and S. Canli and O. Arun and A. Saltali and E. Aydogan and F.N. Akg{\"u}n and C. Sanlikarip and {Mine Karaman}, F. and A. Mazur and S. Vorotyntsev and G. Rousseau and C. Barrett and L. Stancombe and B. Shelley and H. Scholes and J. Limb and A. Rafi and L. Wayman and J. Deane and D. Rogerson and J. Williams and S. Yates and E. Rogers and M. Pulletz and S. Moreton and S. Jones and S. Venkatesh and M. Burton and L. Brown and C. Goodall and M. Rucklidge and D. Fuller and M. Nadolski and S. Kusre and M. Lundberg and L. Everett and H. Nutt and M. Zuleika and P. Carvalho and D. Clements and B. Creagh-Brown and P. Watt and P. Raymode and O. Mohr and A. Raj and T. Creary and A. Chishti and A. Bell and C. Higham and A. Cain and S. Gibb and S. Mowat and D. Franklin and C. West and G. Minto and N. Boyd and E. Calton and R. Walker and F. Mackenzie and B. Ellison and H. Roberts and M. Chikungwa and C. Jackson and A. Donovan and J. Foot and E. Homan and J. Montgomery and D. Portch and P. Mercer and J. Palmer and J. Paddle and A. Fouracres and A. Datson and A. Andrew and L. Welch and A. Rose and S. Varma and K. Simeson and M. Rambhatla and J. Susarla and S. Marri and K. Kodaganallur and A. Das and S. Algarsamy and J. Colley and S. Davies and M. Szewczyk and T. Smith and A. Fernandez-Bustamante and E. Luzier and A. Almagro and L. Fernando and D. Sulemanji and J. Sprung and T. Weingarten and D. Kor and F. Scavonetto and Y. Tze",
year = "2017",
month = "8",
doi = "10.1097/EJA.0000000000000646",
language = "English",
volume = "34",
pages = "492–507",
journal = "European journal of anaesthesiology",
number = "8",

}

TY - JOUR

T1 - Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

T2 - LAS VEGAS - An observational study in 29 countries

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AU - Salciute, E.

AU - Tikuisis, R.

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AU - Jurate, S.

AU - Kontrimaviciute, E.

AU - Tomkute, G.

AU - Xuereb, J.

AU - Bezzina, M.

AU - Borg, F.J.

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AU - Moret, E.

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AU - Monedero, P.

AU - Hidalgo Martinez, F.

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AU - Scholes, H.

AU - Limb, J.

AU - Rafi, A.

AU - Wayman, L.

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AU - Venkatesh, S.

AU - Burton, M.

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AU - Rucklidge, M.

AU - Fuller, D.

AU - Nadolski, M.

AU - Kusre, S.

AU - Lundberg, M.

AU - Everett, L.

AU - Nutt, H.

AU - Zuleika, M.

AU - Carvalho, P.

AU - Clements, D.

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AU - Watt, P.

AU - Raymode, P.

AU - Mohr, O.

AU - Raj, A.

AU - Creary, T.

AU - Chishti, A.

AU - Bell, A.

AU - Higham, C.

AU - Cain, A.

AU - Gibb, S.

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AU - Franklin, D.

AU - West, C.

AU - Minto, G.

AU - Boyd, N.

AU - Calton, E.

AU - Walker, R.

AU - Mackenzie, F.

AU - Ellison, B.

AU - Roberts, H.

AU - Chikungwa, M.

AU - Jackson, C.

AU - Donovan, A.

AU - Foot, J.

AU - Homan, E.

AU - Montgomery, J.

AU - Portch, D.

AU - Mercer, P.

AU - Palmer, J.

AU - Paddle, J.

AU - Fouracres, A.

AU - Datson, A.

AU - Andrew, A.

AU - Welch, L.

AU - Rose, A.

AU - Varma, S.

AU - Simeson, K.

AU - Rambhatla, M.

AU - Susarla, J.

AU - Marri, S.

AU - Kodaganallur, K.

AU - Das, A.

AU - Algarsamy, S.

AU - Colley, J.

AU - Davies, S.

AU - Szewczyk, M.

AU - Smith, T.

AU - Fernandez-Bustamante, A.

AU - Luzier, E.

AU - Almagro, A.

AU - Fernando, L.

AU - Sulemanji, D.

AU - Sprung, J.

AU - Weingarten, T.

AU - Kor, D.

AU - Scavonetto, F.

AU - Tze, Y.

PY - 2017/8

Y1 - 2017/8

N2 - BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.

AB - BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.

UR - http://www.scopus.com/inward/record.url?eid=2-s2.0-85021846260&partnerID=MN8TOARS

U2 - 10.1097/EJA.0000000000000646

DO - 10.1097/EJA.0000000000000646

M3 - Article

VL - 34

SP - 492

EP - 507

JO - European journal of anaesthesiology

JF - European journal of anaesthesiology

IS - 8

ER -