Anaesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, Unité INSERM U1046, Université Montpellier 1, Centre Hospitalier Universitaire Montpellier, Montpellier, France.
Anaesthesia. 2012 Sep;67(9):999-1008. doi: 10.1111/j.1365-2044.2012.07218.x. Epub 2012 Jun 18.
We conducted an observational prospective multicenter study to describe the practices of mechanical ventilation, to determine the incidence of use of large intra-operative tidal volumes (≥10 ml.kg(-1) of ideal body weight) and to identify patient factors associated with this practice. Of the 2960 patients studied in 97 anaesthesia units from 49 hospitals, volume controlled mode was the most commonly used (85%). The mean (SD) tidal volume was 533 (82) ml; 7.7 (1.3) ml.kg(-1) (actual weight) and 8.8 (1.4) ml.kg(-1) (ideal body weight)). The lungs of 381 (18%) patients were ventilated with a tidal volume>10 ml.kg(-1) ideal body weight. Being female (OR 5.58 (95% CI 4.20-7.43)) and by logistic regression, underweight (OR 0.06 (95% CI 0.01-0.45)), overweight (OR 1.98 (95% CI 1.49-2.65)), obese (OR 5.02 (95% CI 3.51-7.16)), severely obese (OR 10.12 (95% CI 5.79-17.68)) and morbidly obese (OR 14.49 (95% CI 6.99-30.03)) were the significant (p ≤ 0.005) independent factors for the use of large tidal volumes during anaesthesia.
我们进行了一项观察性前瞻性多中心研究，以描述机械通气的实践，确定术中使用大潮气量（≥10ml/kg理想体重）的发生率，并确定与该实践相关的患者因素。在 49 家医院的 97 个麻醉单位研究的 2960 名患者中，容量控制模式最常用（85%）。潮气量的平均值（标准差）为 533（82）ml；7.7（1.3）ml/kg（实际体重）和 8.8（1.4）ml/kg（理想体重）。381 名（18%）患者的肺以潮气量>10ml/kg理想体重通气。女性（比值比 5.58（95%置信区间 4.20-7.43））和逻辑回归，体重过轻（比值比 0.06（95%置信区间 0.01-0.45））、超重（比值比 1.98（95%置信区间 1.49-2.65））、肥胖（比值比 5.02（95%置信区间 3.51-7.16））、重度肥胖（比值比 10.12（95%置信区间 5.79-17.68））和病态肥胖（比值比 14.49（95%置信区间 6.99-30.03））是麻醉期间使用大潮气量的显著（p≤0.005）独立因素。
