Current concepts of protective ventilation during general anaesthesia

Swiss Medical Weekly

Volumn 145, Issue , 2015, Pages

  Serpa Neto, Ary ^a,b,c   Schultz, Marcus J ^b   Slutsky, Arthur S ^d,e  

^a HOSPITAL ISRAELITA ALBERT EINSTEIN   (Brazil)

^b UNIVERSITY OF AMSTERDAM   (Netherlands)

^c FACULDADE DE MEDICINA DO ABC   (Brazil)

^d ST MICHAEL'S HOSPITAL   (Canada)

^e UNIVERSITY OF TORONTO   (Canada)

Author keywords

General anaesthesia; Mechanical ventilation; Postoperative pulmonary complications; Surgery

Indexed keywords

OXYGEN;

ADULT RESPIRATORY DISTRESS SYNDROME; ANESTHESIST; ARTIFICIAL VENTILATION; BODY WEIGHT; CRITICALLY ILL PATIENT; GENERAL ANESTHESIA; HEALTH CARE PRACTICE; HUMAN; META ANALYSIS (TOPIC); MULTICENTER STUDY (TOPIC); NONHUMAN; OPERATING ROOM; PATIENT HARM; PEROPERATIVE CARE; POSITIVE END EXPIRATORY PRESSURE; PREDICTED BODY WEIGHT; PREDICTION; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; RISK BENEFIT ANALYSIS; SYSTEMATIC REVIEW (TOPIC); TIDAL VOLUME; ADVERSE EFFECTS; ANIMAL; LUNG INJURY; MORTALITY; PHYSIOLOGY; POSTOPERATIVE COMPLICATIONS; PROCEDURES;

ANESTHESIA, GENERAL; ANIMALS; HUMANS; LUNG INJURY; OXYGEN; POSITIVE-PRESSURE RESPIRATION; POSTOPERATIVE COMPLICATIONS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RESPIRATION, ARTIFICIAL; TIDAL VOLUME;

EID: 84982073745     PISSN: 14247860     EISSN: 14243997     Source Type: Journal    
DOI: 10.4414/smw.2015.14211     Document Type: Review

References (68)

1. Pearse RM, Moreno RP, Bauer P, et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012;380:1059-65.
2. Canet J, Gallart L, Gomar C, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology. 2010;113:1338-50.
3. Mazo V, Sabaté S, Canet J, et al. Prospective external validation of a predictive score for postoperative pulmonary complications. Anesthesiology. 2014;121:219-31.
4. Serpa Neto A, Hemmes SN, Barbas CS, et al. Incidence of mortality and morbidity related to postoperative lung injury in patients who have undergone abdominal or thoracic surgery: a systematic review and meta-analysis. Lancet Respir Med. 2014;2:1007-15.
5. ARDS Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000;342:1301-8.
6. Bendixen HH, Hedley-Whyte J, Laver MB. Impaired oxygenation in surgical patients during general anesthesia with controlled ventilation. A concept of atelectasis. N Engl J Med. 1963;269:991-6.
7. Serpa Neto A, Nagtzaam L, Schultz MJ. Ventilation with lower tidal volumes for critically ill patients without the acute respiratory distress syndrome: a systematic translational review and meta-analysis. Curr Opin Crit Care. 2014; 20:25-32.
8. Slutsky AS, Tremblay LN. Multiple system organ failure. Is mechanical ventilation a contributing factor? Am J Respir Crit Care Med. 1998;157:1721-5.
9. Tremblay L, Valenza F, Ribeiro SP, Li J, Slutsky AS. Injurious ventilatory strategies increase cytokines and c-fos m-RNA expression in an isolated rat lung model. J Clin Invest. 1997;99:944-52.
10. Webb HH, Tierney DF. Experimental pulmonary edema due to intermittent positive pressure ventilation with high inflation pressures. Protection by positive end-expiratory pressure. Am Rev Respir Dis. 1974;110:556-65.
11. Putensen C, Theuerkauf N, Zinserling J, Wrigge H, Pelosi P. Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury. Ann Intern Med. 2009;151:566-76.
12. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013;41:580-637.
13. Determann RM, Royakkers A, Wolthuis EK, et al. Ventilation with lower tidal volumes as compared with conventional tidal volumes for patients without acute lung injury: a preventive randomized controlled trial. Crit Care. 2010;14:R1.
14. Serpa Neto A, Cardoso SO, Manetta JA, et al. Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: a meta-analysis. JAMA. 2012;308:1651-9.
15. Serpa Neto A, Simonis FD, Schultz MJ. How to ventilate patients without acute respiratory distress syndrome? Curr Opin Crit Care. 2015;21:65-73.
16. Serpa Neto A, Simonis FD, Barbas CS, et al. Association between tidal volume size, duration of ventilation, and sedation needs in patients without acute respiratory distress syndrome: an individual patient data meta-analysis. Intensive Care Med. 2014;40:950-7.
17. Treschan TA, Schaefer MS, Subasi L, Kaisers W, Schultz MJ, Beiderlinden M. Evolution of ventilator settings during general anaesthesia for neurosurgery: An observational study in a German centre over 15 years. Eur J Anaesthesiol. 2015;[in press].
18. Wanderer JP, Ehrenfeld JM, Epstein RH, et al. Temporal trends and current practice patterns for intraoperative ventilation at U.S. academic medical centers: a retrospective study. BMC Anesthesiol. 2015;15:40.
19. Chaney MA, Nikolov MP, Blakeman BP, Bakhos M. Protective Ventilation Attenuates Postoperative Pulmonary Dysfunction in Patients Undergoing Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth. 2000;14:514-8.
20. Michelet P, D'Journo XB, Roch A, Doddoli C, Marin V, Papazian L, et al. Protective ventilation influences systemic inflammation after esophagectomy: a randomized controlled study. Anesthesiology. 2006;105:911-9.
21. Zupancich E, Paparella D, Turani F, Munch C, Rossi A, Massaccesi S, et al. Mechanical ventilation affects inflammatory mediators in patients undergoing cardiopulmonary bypass for cardiac surgery: A randomized clinical trial. J Thorac Cardiovasc Surg. 2005;130:378-83.
22. Hemmes SN, Serpa Neto A, Schultz MJ. Intraoperative ventilatory strategies to prevent postoperative pulmonary complications: a meta-analysis. Curr Opin Anaesthesiol. 2013;26:126-33.
23. Severgnini P, Selmo G, Lanza C, et al. Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function. Anesthesiology. 2013;118:1307-21.
24. Futier E, Constantin JM, Paugam-Burtz C, et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med. 2013;369:428-37.
25. Ge Y, Yuan L, Jiang X, Wang X, Xu R, Ma W. Effect of lung protection mechanical ventilation on respiratory function in the elderly undergoing spinal fusion. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013;38:81-5.
26. Serpa Neto A, Hemmes SNT, Barbas CSV, et al. Protective Versus Conventional Ventilation for Surgery: A systematic review and individual patient data meta-analysis. Anesthesiology. 2015; [in press].
27. Tenney SM, Remmers JE. Comparative quantitative morphology of the mammalian lung: Diffusing area. Nature. 1963;197:54-6.
28. Dreyfuss D, Saumon G. Ventilator-induced Lung Injury - Lessons from experimental studies. Am J Respir Crit Care Med. 1998;157:294-323.
29. Slutsky AS, Ranieri VM. Ventilator-induced lung injury. N Engl J Med. 2013;369:2126-36.
30. PROVE Network Investigators for the Clinical Trial Network of the European Society of Anaesthesiology, Hemmes SN, Gama de Abreu M, Pelosi P, Schultz MJ. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial. Lancet. 2014;384:495-503.
31. Hedenstierna G, Edmark L. Mechanisms of atelectasis in the perioperative period. Best Pract Res Clin Anaesthesiol. 2010;24:157-69.
32. Borges JB, Hedenstierna G, Bergman JS, Amato MB, Avenel J, Montmerle-Borgdorff S. First-time imaging of effects of inspired oxygen concentration on regional lung volumes and breathing pattern during hypergravity. Eur J Appl Physiol. 2015;115:353-63.
33. Hanson A, Göthberg S, Nilsson K, Hedenstierna G. Recruitment and PEEP level influences long-time aeration in saline-lavaged piglets: an experimental model. Paediatr Anaesth. 2012;22:1072-9.
34. Blomqvist H, Wickerts CJ, Berg B, Frostell C, Jolin A, Hedenstierna G. Does PEEP facilitate the resolution of extravascular lung water after experimental hydrostatic pulmonary oedema? Eur Respir J. 1991;4:1053-9.
35. Bellardine Black CL, Hoffman AM, Tsai LW, et al. Relationship between dynamic respiratory mechanics and disease heterogeneity in sheep lavage injury. Crit Care Med. 2007;35:870-8.
36. Brower RG, Lanken PN, MacIntyre N, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med. 2004;351:327-36.
37. Mercat A, Richard JC, Vielle B, et al. Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2008;299:646-55.
38. Meade MO, Cook DJ, Guyatt GH, et al. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2008;299:637-45
39. Briel M, Meade M, Mercat A, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA. 2010;303:865-73.
40. Suzumura EA, Figueiró M, Normilio-Silva K, et al. Effects of alveolar recruitment maneuvers on clinical outcomes in patients with acute respiratory distress syndrome: a systematic review and meta-analysis. Intensive Care Med. 2014;40:1227-40.
41. Manzano F, Fernández-Mondéjar E, Colmenero M, et al. Positive-end expiratory pressure reduces incidence of ventilator-associated pneumonia in nonhypoxemic patients. Crit Care Med. 2008;36:2225-31.
42. Pepe PE, Hudson LD, Carrico CJ. Early application of positive endexpiratory pressure in patients at risk for the adult respiratory-distress syndrome. N Engl J Med. 1984;311:281-6.
43. Esteban A, Anzueto A, Frutos F, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA. 2002;287:345-55.
44. Esteban A, Ferguson ND, Meade MO, et al. Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med. 2008;177:170-7.
45. Esteban A, Frutos-Vivar F, Muriel A, et al. Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med. 2013;188:220-30.
46. Levin MA, McCormick PJ, Lin HM, Hosseinian L, Fischer GW. Low intraoperative tidal volume ventilation with minimal PEEP is associated with increased mortality. Br J Anaesth. 2014;113:97-108.
47. Futier E, Constantin JM, Petit A, et al. Positive end-expiratory pressure improves end-expiratory lung volume but not oxygenation after induction of anaesthesia. Eur J Anaesthesiol. 2010;27:508-13.
48. Neumann P, Rothen HU, Berglund JE, Valtysson J, Magnusson A, Hedenstierna G. Positive end-expiratory pressure prevents atelectasis during general anaesthesia even in the presence of a high inspired oxygen concentration. Acta Anaesthesiol Scand. 1999;43:295-301.
49. Maisch S, Reissmann H, Fuellekrug B, et al. Compliance and dead space fraction indicate an optimal level of positive end-expiratory pressure after recruitment in anesthetized patients. Anesth Analg. 2008;106:175-81.
50. Schultz MJ, Haitsma JJ, Slutsky AS, Gajic O. What tidal volumes should be used in patients without acute lung injury? Anesthesiology. 2007;106:1226-31.
51. de Graaff AE, Dongelmans DA, Binnekade JM, de Jonge E. Clinicians' response to hyperoxia in ventilated patients in a Dutch ICU depends on the level of FiO2. Intensive Care Med. 2011;37:46-51.
52. Hovaguimian F, Lysakowski C, Elia N, Tramèr MR. Effect of intraoperative high inspired oxygen fraction on surgical site infection, postoperative nausea and vomiting, and pulmonary function: systematic review and meta-analysis of randomized controlled trials. Anesthesiology. 2013;119:303-16.
53. Togioka B, Galvagno S, Sumida S, Murphy J, Ouanes JP, Wu C. The role of perioperative high inspired oxygen therapy in reducing surgical site infection: a meta-analysis. Anesth Analg. 2012;114:334-42.
54. Bhandari V, Elias JA: Cytokines in tolerance to hyperoxia-induced injury in the developing and adult lung. Free Radic Biol Med. 2006;41:4-18.
55. Aggarwal NR, Brower RG. Targeting normoxemia in acute respiratory distress syndrome may cause worse short-term outcomes because of oxygen toxicity. Ann Am Thorac Soc 2014;11:1449-53.
56. Kallet RH, Matthay MA. Hyperoxic acute lung injury. Respir Care 2013;58:123-40.
57. de Jonge E, Peelen L, Keijzers PJ, et al. Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients. Crit Care. 2008;12:R156.
58. Altemeier WA, Sinclair SE. Hyperoxia in the intensive care unit: why more is not always better. Curr Opin Crit Care. 2007;13:73-8.
59. Kilgannon JH, Jones AE, Shapiro NI, et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA. 2010;303:2165-71.
60. Cornet AD, Kooter AJ, Peters MJ, Smulders YM. Supplemental oxygen therapy in medical emergencies: more harm than benefit? Arch Intern Med. 2012;172:289-90.
61. Davis DP, Meade W, Sise MJ, et al. Both hypoxemia and extreme hyperoxemia may be detrimental in patients with severe traumatic brain injury. J Neurotrauma. 2009;26:2217-23.
62. Damiani E, Adrario E, Girardis M, et al. Arterial hyperoxia and mortality in critically ill patients: a systematic review and meta-analysis. Crit Care. 2014;18:711.
63. Helmerhorst HJ, Roos-Blom MJ, van Westerloo DJ, de Jonge E. Association Between Arterial Hyperoxia and Outcome in Subsets of Critical Illness: A Systematic Review, Metaanalysis, and Meta-Regression of Cohort Studies. Crit Care Med. 2015;43:1508-19.
64. Staehr-Rye AK, Eikermann M. Eliminate postoperative respiratory complications: preoperative screening opens the door to clinical pathways that individualise perioperative treatment. Eur J Anaesthesiol. 2015;32:455-7.
65. Canet J, Sabaté S, Mazo Valentín, et al. Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort: A prospective, observational study. Eur J Anaesthesiol. 2015;32:458-70.
66. Technische Universität Dresden. Protective Ventilation With Higher Versus Lower PEEP During General Anesthesia for Surgery in Obese Patients (PROBESE). In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited 2015 Apr 17]. Available from: http://clinicaltrials.gov/show/NCT02148692 NLM Identifier: NCT02148692.
67. Assistance Publique - Hôpitaux de Paris. Pulmonary Surgery and Protective Mechanical Ventilation (VPP). In: ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000- [cited 2015 Apr 17]. Available from: http://clinicaltrials.gov/show/NCT00805077 NLM Identifier: NCT00805077.
68. Schultz MJ (2015, April 17). Protective ventilation during thoracic surgery (PROTHORAX). Retrieved from: https://sites.google.com/site/proveneteu/provenet-studies