Publication:
Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

Issued Date

2021-10-01

Resource Type

Article

ISSN

13652346

DOI

10.1097/EJA.0000000000001476

Other identifier(s)

2-s2.0-85116958703

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

European journal of anaesthesiology. Vol.38, No.10 (2021), 1034-1041

Suggested Citation

Sunny G. Nijbroek, Liselotte Hol, Pien Swart, Sabrine N.T. Hemmes, Ary Serpa Neto, Jan M. Binnekade, Goran Hedenstierna, Samir Jaber, Michael Hiesmayr, Markus W. Hollmann, Gary H. Mills, Marcos F. Vidal Melo, Christian Putensen, Werner Schmid, Paolo Severgnini, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J. Schultz Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study. European journal of anaesthesiology. Vol.38, No.10 (2021), 1034-1041. doi:10.1097/EJA.0000000000001476 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/77806

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Title

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

Author(s)

Sunny G. Nijbroek
 Liselotte Hol
 Pien Swart
 Sabrine N.T. Hemmes
 Ary Serpa Neto
 Jan M. Binnekade
 Goran Hedenstierna
 Samir Jaber
 Michael Hiesmayr
 Markus W. Hollmann
 Gary H. Mills
 Marcos F. Vidal Melo
 Christian Putensen
 Werner Schmid
 Paolo Severgnini
 Hermann Wrigge
 Marcelo Gama de Abreu
 Paolo Pelosi
 Marcus J. Schultz

Other Contributor(s)

Monash University

Abstract

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT. CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV. TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223.

Keyword(s)

Medicine

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URI

https://repository.li.mahidol.ac.th/handle/123456789/77806

Collections

Scopus 2021