Effect of ventilation mode on postoperative pulmonary complications among intermediate- to high-risk patients undergoing abdominal surgery: A randomized controlled trial

IF 3.7 3区医学 Q1 ANESTHESIOLOGY

Anaesthesia Critical Care & Pain Medicine Pub Date : 2024-09-13 DOI:10.1016/j.accpm.2024.101423

Xuefei Li , Yi Xu , Zaili Wang , Weiwei Wang , Qiansu Luo , Qianglin Yi , Hai Yu

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引用次数: 0

Abstract

Background

The effect of different mechanical ventilation modes on pulmonary outcome after abdominal surgery remains unclear. We evaluated the effects of three common ventilation modes on postoperative pulmonary complications (PPCs) among intermediate- to high-risk patients undergoing abdominal surgery.

Methods

This randomized clinical trial enrolled adult patients at intermediate or high risk of PPCs who were scheduled for abdominal surgery. Participants were randomized to receive one of three modes of mechanical ventilation modes: volume-controlled ventilation (VCV), pressure-controlled ventilation (PCV), and pressure-control with volume-guaranteed ventilation (PCV-VG). Lung-protective ventilation strategy was implemented in all groups. The primary outcome was the incidence of a composite of pulmonary complications within the first 7 postoperative days. Pulmonary complications within 30 postoperative days, the severity grade of PPCs, and other secondary outcomes were also analyzed.

Results

A total of 1365 patients were randomized and 1349 were analyzed. The primary outcome occurred in 98 (21.8%) in the VCV group, 95 (22.1%) in the PCV group, and 101 (22.5%) in the PCV-VG group (P = 0.865). Additionally, there were no statistically significant differences among the three groups in terms of the incidence of pulmonary complications within postoperative 30 days, severity grade of PPCs, and other secondary outcomes.

Conclusion

In intermediate- to high-risk patients undergoing abdominal surgery, the choice of ventilation mode did not affect the risk of PPCs.

Trial Registration

Chinese Clinical Trial Registry, entry ChiCTR1900025880.

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通气模式对腹部手术中高危患者术后肺部并发症的影响：随机对照试验。

背景：不同的机械通气模式对腹部手术后肺部预后的影响仍不明确。我们评估了三种常见通气模式对腹部手术中高危患者术后肺部并发症（PPCs）的影响：这项随机临床试验招募了计划接受腹部手术的中高危成人患者。参与者被随机分配接受三种机械通气模式中的一种：容量控制通气（VCV）、压力控制通气（PCV）和带容量保证的压力控制通气（PCV-VG）。所有组别均采用肺保护通气策略。主要结果是术后 7 天内肺部并发症的综合发生率。此外，还分析了术后 30 天内的肺部并发症、PPCs 的严重程度等级以及其他次要结果：共有 1365 名患者接受了随机治疗，其中 1349 人接受了分析。VCV 组有 98 例（21.8%）、PCV 组有 95 例（22.1%）、PCV-VG 组有 101 例（22.5%）出现主要结局（P = 0.865）。此外，在术后 30 天内肺部并发症的发生率、PPCs 的严重程度等级以及其他次要结果方面，三组之间没有显著的统计学差异：结论：对于接受腹部手术的中高危患者，通气模式的选择不会影响PPCs的风险：试验注册：中国临床试验注册中心，注册号：ChiCTR1900025880。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anaesthesia Critical Care & Pain Medicine ANESTHESIOLOGY-

CiteScore

6.70

自引率

5.50%

发文量

150

审稿时长

18 days

期刊介绍： Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.