?? Paper of the day

Intraoperative Mechanical Power and Postoperative Pulmonary Complications in Noncardiothoracic Elective Surgery Patients: A 10-Year Retrospective Cohort Study

Published in Anaesthesiology

https://pubs.asahq.org/anesthesiology/article/140/3/399/139427/Intraoperative-Mechanical-Power-and-Postoperative?s=09

Summary:

This article presents a retrospective cohort study conducted at Lille University Hospital, France, to investigate the association between intraoperative ventilation parameters and postoperative pulmonary complications (PPCs) in noncardiac, nonthoracic elective surgery patients. The study included 33,701 adults undergoing surgery between January 2010 and December 2019, and the results indicated that specific ventilation parameters such as lower tidal volume, reduced compliance, increased mechanical power, and decreased end-tidal carbon dioxide were independently associated with an increased risk of PPCs. Patients with PPCs had higher rates of admission to the intensive care unit, longer hospital stays, and higher in-hospital and 1-year mortality rates.

?? takeaways:

1. Lower tidal volume to predicted body weight ratio, reduced compliance, increased mechanical power, and decreased end-tidal carbon dioxide were associated with higher risk of postoperative pulmonary complications.

2. Patients with PPCs had higher rates of ICU admission, longer hospital stays, and increased in-hospital and 1-year mortality rates.

3. Mechanical power during intraoperative ventilation may have a role in the subsequent development of lung damage.

Counter arguments:

1. The study findings are based on retrospective data analysis and may not account for all potential confounding factors or external variables that could influence postoperative pulmonary complications.

2. The study focused on a single-center cohort in France, which may limit the generalization of the findings to other healthcare settings or patient populations.