Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries
Issued Date
2022-12-01
Resource Type
eISSN
14712253
Scopus ID
2-s2.0-85122441135
Pubmed ID
34996361
Journal Title
BMC Anesthesiology
Volume
22
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Anesthesiology Vol.22 No.1 (2022)
Suggested Citation
Hol L., Nijbroek S.G.L.H., Neto A.S., Hemmes S.N.T., Hedenstierna G., Hiesmayr M., Hollmann M.W., Mills G.H., Vidal Melo M.F., Putensen C., Schmid W., Severgnini P., Wrigge H., de Abreu M.G., Pelosi P., Schultz M.J. Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries. BMC Anesthesiology Vol.22 No.1 (2022). doi:10.1186/s12871-021-01560-x Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85365
Title
Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries
Author's Affiliation
Universitätsklinikum Carl Gustav Carus Dresden
IRCCS San Martino Polyclinic Hospital
Universitätsklinikum Bonn
Massachusetts General Hospital
Università degli Studi di Genova
Cleveland Clinic Foundation
Monash University
Mahidol University
Medizinische Universität Wien
Nuffield Department of Medicine
Università degli Studi dell'Insubria
Uppsala Universitet
The University of Sheffield
Amsterdam UMC - University of Amsterdam
Bermannstrost Hospital Halle
IRCCS San Martino Polyclinic Hospital
Universitätsklinikum Bonn
Massachusetts General Hospital
Università degli Studi di Genova
Cleveland Clinic Foundation
Monash University
Mahidol University
Medizinische Universität Wien
Nuffield Department of Medicine
Università degli Studi dell'Insubria
Uppsala Universitet
The University of Sheffield
Amsterdam UMC - University of Amsterdam
Bermannstrost Hospital Halle
Other Contributor(s)
Abstract
Background: The aim of this analysis is to determine geo–economic variations in epidemiology, ventilator settings and outcome in patients receiving general anesthesia for surgery. Methods: Posthoc analysis of a worldwide study in 29 countries. Lower and upper middle–income countries (LMIC and UMIC), and high–income countries (HIC) were compared. The coprimary endpoint was the risk for and incidence of postoperative pulmonary complications (PPC); secondary endpoints were intraoperative ventilator settings, intraoperative complications, hospital stay and mortality. Results: Of 9864 patients, 4% originated from LMIC, 11% from UMIC and 85% from HIC. The ARISCAT score was 17.5 [15.0–26.0] in LMIC, 16.0 [3.0–27.0] in UMIC and 15.0 [3.0–26.0] in HIC (P =.003). The incidence of PPC was 9.0% in LMIC, 3.2% in UMIC and 2.5% in HIC (P <.001). Median tidal volume in ml kg− 1 predicted bodyweight (PBW) was 8.6 [7.7–9.7] in LMIC, 8.4 [7.6–9.5] in UMIC and 8.1 [7.2–9.1] in HIC (P <.001). Median positive end–expiratory pressure in cmH2O was 3.3 [2.0–5.0]) in LMIC, 4.0 [3.0–5.0] in UMIC and 5.0 [3.0–5.0] in HIC (P <.001). Median driving pressure in cmH2O was 14.0 [11.5–18.0] in LMIC, 13.5 [11.0–16.0] in UMIC and 12.0 [10.0–15.0] in HIC (P <.001). Median fraction of inspired oxygen in % was 75 [50–80] in LMIC, 50 [50–63] in UMIC and 53 [45–70] in HIC (P <.001). Intraoperative complications occurred in 25.9% in LMIC, in 18.7% in UMIC and in 37.1% in HIC (P <.001). Hospital mortality was 0.0% in LMIC, 1.3% in UMIC and 0.6% in HIC (P =.009). Conclusion: The risk for and incidence of PPC is higher in LMIC than in UMIC and HIC. Ventilation management could be improved in LMIC and UMIC. Trial registration: Clinicaltrials.gov, identifier: NCT01601223.