• Mohamad El-Khatib, Carine Zeeni, Fadia M Shebbo, Cynthia Karam, Bilal Safi, Aline Toukhtarian, Nancy Abou Nafeh, Samar Mkhayel, ShadidCarol AbiCADepartment of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, PO-Box: 11-0236, Beirut, 1107 2020, Lebanon., Sana Chalhoub, and Jean Beresian.
• Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, PO-Box: 11-0236, Beirut, 1107 2020, Lebanon.
• BMC Anesthesiol. 2024 Feb 27; 24 (1): 8282.

BackgroundInadequate 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.MethodsTwo-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.ResultsOut 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/m2 vs. 26.8 ± 4.9 kg.m2, p < 0.001; 9.1 ± 1.9 ml/kg vs. 8.6 ± 1.4 ml/kg, p = 0.02; 20 ± 4.9 cmH2O vs. 18 ± 3.7 cmH2O, 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].ConclusionsHigh 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.Clinical Trial RegistrationNCT03551899; 24/02/2017.© 2024. The Author(s).

17 keywords...

hide…