Effect of intraoperative PEEP with recruitment maneuvers on the occurrence of postoperative pulmonary complications during general anesthesia--protocol for Bayesian analysis of three randomized clinical trials of intraoperative ventilation.

Autor:	Mazzinari G; Perioperative Medicine, Instituto de Investigación Sanitaria la Fe, Valencia, Spain, 46026, Spain.; Anesthesiology, Hospital Universitario y Politécnico la Fe, Valencia, Spain, 46026, Spain., Zampieri FG; Academic Research Organization, Albert Einstein Hospital, Sao Paulo, Brazil., Ball L; Surgical sciences and integrated diagnostics, University of Genoa, Genoa, Italy.; IRCCS Policlinico San Martino, Genoa, Italy., Campos NS; Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.; Cardio pulmonary department, Instituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidad de de Sao Paulo, Sao Paulo, Brazil., Bluth T; Pulmonary Engineergin group, Anesthesiology and intensive Care, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Hemmes SNT; Anesthesiology, Amsterdam University Medical Centers, location 'AMC', Amsterdam, The Netherlands.; Intensive Care, Amsterdam University Medical Centers, location 'AMC', Amsterdam, The Netherlands., Ferrando C; CIBER (Center of Biomedical Research in Respiratory Diseases, Instituto de Salud Carlos III, Madrid, Spain.; Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Institut D'investigació August Pi i Sunyer, Barcelona, Spain., Librero J; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain., Soro M; INCLIVA Clinical Research Institute, Hospital Clinico Universitario de Valencia, Valencia, Spain., Pelosi P; Surgical sciences and integrated diagnostics, University of Genoa, Genoa, Italy.; IRCCS Policlinico San Martino, Genoa, Italy., Gama de Abreu M; Pulmonary Engineergin group, Anesthesiology and intensive Care, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Schultz MJ; Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of tropical medicine, Mahidol University, Bangkok, Thailand.; Intensive Care, Amsterdam University Medical Centers, location 'AMC', Amsterdam, The Netherlands., Serpa Neto A; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Australia.; Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, Australia.; Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.; Cardio pulmonary department, Instituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidad de de Sao Paulo, Sao Paulo, Brazil.; Intensive Care, Amsterdam University Medical Centers, location 'AMC', Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	F1000Research [F1000Res] 2023 Jun 23; Vol. 11, pp. 1090. Date of Electronic Publication: 2023 Jun 23 (Print Publication: 2022).
DOI:	10.12688/f1000research.125861.2
Abstrakt:	Background: Using the frequentist approach, a recent meta-analysis of three randomized clinical trials in patients undergoing intraoperative ventilation during general anesthesia for major surgery failed to show the benefit of ventilation that uses high positive end-expiratory pressure with recruitment maneuvers when compared to ventilation that uses low positive end-expiratory pressure without recruitment maneuvers. Methods: We designed a protocol for a Bayesian analysis using the pooled dataset. The multilevel Bayesian logistic model will use the individual patient data. Prior distributions will be prespecified to represent a varying level of skepticism for the effect estimate. The primary endpoint will be a composite of postoperative pulmonary complications (PPC) within the first seven postoperative days, which reflects the primary endpoint of the original studies. We preset a range of practical equivalence to assess the futility of the intervention with an interval of odds ratio (OR) between 0.9 and 1.1 and assess how much of the 95% of highest density interval (HDI) falls between the region of practical equivalence. Ethics and dissemination: The used data derive from approved studies that were published in recent years. The findings of this current analysis will be reported in a new manuscript, drafted by the writing committee on behalf of the three research groups. All investigators listed in the original trials will serve as collaborative authors. Competing Interests: No competing interests were disclosed. (Copyright: © 2023 Mazzinari G et al.)
Databáze:	MEDLINE
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