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
Issued Date
2022-01-01
Resource Type
ISSN
20461402
eISSN
1759796X
Scopus ID
2-s2.0-85153280925
Pubmed ID
37234075
Journal Title
F1000Research
Volume
11
Rights Holder(s)
SCOPUS
Bibliographic Citation
F1000Research Vol.11 (2022)
Suggested Citation
Mazzinari G. 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. F1000Research Vol.11 (2022). doi:10.12688/f1000research.125861.1 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86887
Title
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
Author(s)
Author's Affiliation
Universitätsklinikum Carl Gustav Carus Dresden
Mahidol Oxford Tropical Medicine Research Unit
Melbourne Medical School
IRCCS San Martino Polyclinic Hospital
Instituto de Investigación Sanitaria La Fe
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Hospital Universitari i Politècnic La Fe
Hospital Clinic Barcelona
Università degli Studi di Genova
Monash University
Hospital Israelita Albert Einstein
Hospital Clinico Universitario de Valencia
Nuffield Department of Medicine
Universidade de São Paulo
Amsterdam UMC - University of Amsterdam
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)
Mahidol Oxford Tropical Medicine Research Unit
Melbourne Medical School
IRCCS San Martino Polyclinic Hospital
Instituto de Investigación Sanitaria La Fe
Centro de Investigación Biomédica en Red de Enfermedades Respiratorias
Hospital Universitari i Politècnic La Fe
Hospital Clinic Barcelona
Università degli Studi di Genova
Monash University
Hospital Israelita Albert Einstein
Hospital Clinico Universitario de Valencia
Nuffield Department of Medicine
Universidade de São Paulo
Amsterdam UMC - University of Amsterdam
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC)
Other Contributor(s)
Abstract
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.