dc.contributor.author | LAS VEGAS investigators | en_US |
dc.date.accessioned | 2018-05-01T12:35:40Z | |
dc.date.issued | 2017-08 | en_US |
dc.date.submitted | 2018-03-09T08:02:52.434Z | |
dc.identifier.uri | http://qmro.qmul.ac.uk/xmlui/handle/123456789/36609 | |
dc.description.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 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. TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, number NCT01601223. | en_US |
dc.description.sponsorship | The LAS VEGAS study was endorsed and partly funded by a research grant from the
European Society of Anaesthesiology through their Clinical Trial Network. | en_US |
dc.format.extent | 492 - 507 | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | Eur J Anaesthesiol | en_US |
dc.subject | Aged | en_US |
dc.subject | Aged, 80 and over | en_US |
dc.subject | Anesthesia, General | en_US |
dc.subject | Cross-Sectional Studies | en_US |
dc.subject | Female | en_US |
dc.subject | Humans | en_US |
dc.subject | Internationality | en_US |
dc.subject | Intraoperative Care | en_US |
dc.subject | Lung | en_US |
dc.subject | Male | en_US |
dc.subject | Middle Aged | en_US |
dc.subject | Postoperative Complications | en_US |
dc.subject | Prospective Studies | en_US |
dc.subject | Respiration Disorders | en_US |
dc.subject | Respiration, Artificial | en_US |
dc.subject | Risk Factors | en_US |
dc.subject | Tidal Volume | en_US |
dc.subject | Treatment Outcome | en_US |
dc.title | Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - an observational study in 29 countries. | en_US |
dc.type | Article | |
dc.identifier.doi | 10.1097/EJA.0000000000000646 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/28633157 | en_US |
pubs.issue | 8 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published | en_US |
pubs.volume | 34 | en_US |