High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial

Autor: Hemmes, SNT, de Abreu, MG, Pelosi, P, Schultz, MJ, Severgnini, P, Hollmann, MW, Binnekade, JM, Wrigge, H, Canet, J, Hiesmayr, M, Schmid, W, Jaber, S, Hedenstierna, G, Putensen, C, Sessler, DI, Lachmann, B, Slutsky, AS, De Baerdemaeker, L, De Hert, S, Heyse, B, Van Limmen, J, Mulier, JP, Velghe, D, Jamaer, L, Vandenbrande, J, Bugedo, G, Florez, J, Goranovic, T, Mazul-Sunko, B, Bluth, T, Guldner, A, Kiss, T, Koch, T, Spieth, PM, Uhlig, C, Yaqub, J, Bastin, B, Geib, J, Schaefer, MS, Weiss, M, Treschan, TA, Reske, AW, Simon, P, Ferner, ABM, Hartmann, E, Laufenberg-Feldmann, R, Strys, L, De Robertis, E, Perilli, V, Proietti, R, Amantea, B, Caroleo, S, Tropea, F, Bacuzzi, A, Vanoni, M, Cinnella, G, Caggianelli, G, D'Antini, D, La Bella, D, Mollica, G, Cortegiani, A, Giarratano, A, Montalto, F, Raineri, SM, Barberis, B, Celentano, C, Grio, M, Spagnolo, L, Gratarola, A, Molin, A, Pellerano, G, Pezzato, S, Rusca, R, Della Rocca, G, Bos, LD, Brunelli, A, Marti, A, Cegarra, V, Merten, A, Moral, MV, Parera, A, Unzueta, MC, Sabate, S, Sierra, P, Mayoral, JF, Prieto, M, Gil, MG, Marin, CM, Mills, GH, Bodger, P, Melo, MFV, Sulemanji, D, Sprung, J, De Bruyne, A, Ongena, P, Bleyl, JU, Koch, M, Muller, M, Rossel, T, Saeger, HD, Weitz, J, Babian, R, Rathmann, AM, Pochert, J, Dathe, M, Chiaravalloti, F, Madia, D, Pezzoli, I, Caruso, A, Bianco, MF, Picicco, F, Mirabella, L, Rauseo, M, Anguilano, R, Palmeri, C, Strano, MT, Federico, A, Pompei, L, Buttera, S, Everingham, K, Han, R, Hewson, R, Januszewska, M, Mohr, O, Pearse, R, Raj, A, Oto, J, Kacmarek, RM, Weingarten, TN
Rok vydání: 2014
Zdroj: LANCET
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
ISSN: 0140-6736
Popis: Background The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H2O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level of positive end-expiratory pressure with recruitment manoeuvres protects against postoperative pulmonary complications in patients at risk of complications who are receiving mechanical ventilation with low tidal volumes during general anaesthesia for open abdominal surgery. Methods In this randomised controlled trial at 30 centres in Europe and North and South America, we recruited 900 patients at risk for postoperative pulmonary complications who were planned for open abdominal surgery under general anaesthesia and ventilation at tidal volumes of 8 mL/kg. We randomly allocated patients to either a high level of positive end-expiratory pressure (12 cm H2O) with recruitment manoeuvres (higher PEEP group) or a low level of pressure (
Databáze: OpenAIRE
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