Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, PO-Box: 11-0236, Beirut, 1107 2020, Lebanon.
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
BMC Anesthesiol. 2024 Feb 27;24(1):82. doi: 10.1186/s12871-024-02449-1.
Inadequate intraoperative mechanical ventilation (MV) can lead to ventilator-induced lung injury and increased risk for postoperative pulmonary complications (PPCs). Mechanical power (MP) was shown to be a valuable indicator for MV outcomes in critical care patients. The aim of this study is to assess the association between intraoperative MP in low-risk surgical patients undergoing general anesthesia and PPCs.
Two-hundred eighteen low-risk surgical patients undergoing general anesthesia for elective surgery were included in the study. Intraoperative mechanical ventilatory support parameters were collected for all patients. Postoperatively, patients were followed throughout their hospital stay and up to seven days post discharge for the occurrence of any PPCs.
Out of 218 patients, 35% exhibited PPCs. The average body mass index, tidal volume per ideal body weight, peak inspiratory pressure, and MP were significantly higher in the patients with PPCs than in the patients without PPCs (30.3 ± 8.1 kg/m vs. 26.8 ± 4.9 kg.m, p < 0.001; 9.1 ± 1.9 ml/kg vs. 8.6 ± 1.4 ml/kg, p = 0.02; 20 ± 4.9 cmHO vs. 18 ± 3.7 cmHO, p = 0.001; 12.9 ± 4.5 J/min vs. 11.1 ± 3.7 J/min, p = 0.002). A multivariable regression analysis revealed MP as the sole significant predictor for the risk of postoperative pulmonary complications [OR 1.1 (95% CI 1.0-1.2, p = 0.036].
High intraoperative mechanical power is a risk factor for developing postoperative pulmonary complications. Furthermore, intraoperative mechanical power is superior to other traditional mechanical ventilation variables in identifying surgical patients who are at risk for developing postoperative pulmonary complications.
NCT03551899; 24/02/2017.
术中机械通气（MV）不足可导致呼吸机相关性肺损伤和术后肺部并发症（PPCs）风险增加。机械功率（MP）已被证明是重症监护患者 MV 结果的一个有价值的指标。本研究旨在评估接受全身麻醉的低危手术患者术中 MP 与 PPCs 之间的关联。
本研究纳入 218 例接受全身麻醉择期手术的低危手术患者。收集所有患者术中机械通气支持参数。术后，对患者进行随访，直至住院期间和出院后 7 天，以了解任何 PPCs 的发生情况。
在 218 例患者中，有 35%出现 PPCs。与无 PPCs 的患者相比，有 PPCs 的患者的平均 BMI、每理想体重的潮气量、吸气峰压和 MP 明显更高（30.3 ± 8.1 kg/m 与 26.8 ± 4.9 kg.m，p < 0.001；9.1 ± 1.9 ml/kg 与 8.6 ± 1.4 ml/kg，p = 0.02；20 ± 4.9 cmHO 与 18 ± 3.7 cmHO，p = 0.001；12.9 ± 4.5 J/min 与 11.1 ± 3.7 J/min，p = 0.002）。多变量回归分析显示，MP 是术后肺部并发症风险的唯一显著预测因子[比值比 1.1（95%置信区间 1.0-1.2，p = 0.036]。
术中高机械功率是发生术后肺部并发症的危险因素。此外，与其他传统机械通气变量相比，术中机械功率在识别可能发生术后肺部并发症的手术患者方面更具优势。
NCT03551899；2017 年 2 月 24 日。
