Intraoperative ventilatory strategies to prevent postoperative pulmonary complications: a meta-analysis

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art_HEMMES_Intraoperative_ventilatory_strategies_to_prevent_postoperative_pulmonary_complications_2013.PDF (458.9 KB)
Citações na Scopus
116
Tipo de produção
article
Data de publicação
2013
Editora
LIPPINCOTT WILLIAMS & WILKINS
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
HEMMES, Sabrine N. T.
SCHULTZ, Marcus J.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
CURRENT OPINION IN ANESTHESIOLOGY, v.26, n.2, p.126-133, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Purpose of review It is uncertain whether patients undergoing short-lasting mechanical ventilation for surgery benefit from lung-protective intraoperative ventilatory settings including the use of lower tidal volumes, higher levels of positive end-expiratory pressure (PEEP) and/or recruitment maneuvers. We meta-analyzed trials testing the effect of lung-protective intraoperative ventilatory settings on the incidence of postoperative pulmonary complications. Recent findings Eight articles (1669 patients) were included. Meta-analysis showed a decrease in lung injury development [risk ratio (RR) 0.40; 95% confidence interval (CI) 0.22-0.70; I-2 0%; number needed to treat (NNT) 37], pulmonary infection (RR 0.64; 95% CI 0.43-0.97; I-2 0%; NNT 27) and atelectasis (RR 0.67; 95% CI 0.47-0.96; I-2 48%; NNT 31) in patients receiving intraoperative mechanical ventilation with lower tidal volumes. Meta-analysis also showed a decrease in lung injury development (RR 0.29; 95% CI 0.14-0.60; I-2 0%; NNT 29), pulmonary infection (RR 0.62; 95% CI 0.40-0.96; I-2 15%; NNT 33) and atelectasis (RR 0.61; 95% CI 0.41-0.91; I-2 0%; NNT 29) in patients ventilated with higher levels of PEEP, with or without recruitment maneuvers. Summary Lung-protective intraoperative ventilatory settings have the potential to protect against postoperative pulmonary complications.
Palavras-chave
intraoperative, mechanical ventilation, positive end-expiratory pressure, postoperative complications, tidal volume
URI
https://observatorio.fm.usp.br/handle/OPI/7748
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Coleções
Artigos e Materiais de Revistas Científicas - FM/Outros