Scopus
🔓 Açık Erişim YÖKSİS Eşleşti
Associations of intraoperative end–tidal CO<inf>2</inf> levels with postoperative outcome–secondary analysis of a worldwide observational study
Journal of Clinical Anesthesia · Şubat 2025
YÖKSİS Kayıtları
Associations of intraoperative end-tidal CO2 levels with postoperative outcome-secondary analysis of a worldwide observational study
J Clin Anesth . · 2025 SCI-Expanded
PROFESÖR OĞUZHAN ARUN →
Associations of intraoperative end–tidal CO2 levels with postoperative outcome–secondary analysis of a worldwide observational study
Journal of Clinical Anesthesia · 2024 SCI
PROFESÖR OĞUZHAN ARUN →
Makale Bilgileri
DergiJournal of Clinical Anesthesia
Yayın TarihiŞubat 2025
Cilt / Sayfa101
Scopus ID2-s2.0-85212532958
Erişim🔓 Açık Erişim
Özet
Background: Patients receiving intraoperative ventilation during general anesthesia often have low end–tidal CO2 (etCO2). We examined the association of intraoperative etCO2 levels with the occurrence of postoperative pulmonary complications (PPCs) in a conveniently–sized international, prospective study named ‘Local ASsessment of Ventilatory management during General Anesthesia for Surgery’ (LAS VEGAS). Methods: Patients at high risk of PPCs were categorized as ‘low etCO2’ or ‘normal to high etCO2’ patients, using a cut–off of 35 mmHg. The primary endpoint was a composite of previously defined PPCs; the individual PPCs served as secondary endpoints. The need for unplanned oxygen was defined as mild PPCs and severe PPCs included pneumonia, respiratory failure, acute respiratory distress syndrome, barotrauma, and new invasive ventilation. We performed propensity score matching and LOESS regression to evaluate the relationship between the lowest etCO2 and PPCs. Results: The analysis included 1843 (74 %) ‘low etCO2’ patients and 648 (26 %) ‘normal to high etCO2’ patients. There was no difference in the occurrence of PPCs between ‘low etCO2’ and ‘normal to high etCO2’ patients (20 % vs. 19 %; RR 1.00 [95 %–confidence interval 0.94 to 1.06]; P = 0.84). The proportion of severe PPCs among total occurring PPCs, were higher in ‘low etCO2’ patients compared to ‘normal to high etCO2’ patients (35 % vs. 18 %; RR 1.16 [1.08 to 1.25]; P < 0.001). Propensity score matching did not change these findings. LOESS plot showed an inverse relationship of intraoperative etCO2 levels with the occurrence of PPCs. Conclusions: In this cohort of patients at high risk of PPCs, the overall occurrence of PPCs was not different between ‘low etCO2’ patients and ‘normal to high etCO2’ patients, but severe PPCs occurred more often in ‘low etCO2’, with an inverse dose–dependent relationship between intraoperative etCO2 levels and PPCs. Funding: This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anesthesiology and Intensive Care (ESAIC) and the Amsterdam University Medical Centers, location ‘AMC’. Registration: LAS VEGAS was registered at Clinicaltrials.gov (NCT01601223), first posted on May 17, 2012.
Yazarlar (100)
1
Prashant Nasa
2
David M. van Meenen
3
Frederique Paulus
4
Marcelo Gama de Abreu
5
Sebastiaan M. Bossers
6
Patrick Schober
7
Marcus J. Schultz
8
Ary Serpa Neto
9
Sabrine N.T. Hemmes
10
Wolfgang Kroell
11
Helfried Metzler
12
Gerd Struber
13
Thomas Wegscheider
14
Hans Gombotz
15
Michael Hiesmayr
16
Werner Schmid
17
Bernhard Urbanek
18
David Kahn
19
Mona Momeni
20
Audrey Pospiech
21
Fernande Lois
22
Patrice Forget
23
Irina Grosu
24
Jan Poelaert
25
Veerle van Mossevelde
26
Marie Claire van Malderen
27
Dimitri Dylst
28
Jeroen van Melkebeek
29
Maud Beran
30
Stefan De Hert
31
Luc De Baerdemaeker
32
Bjorn Heyse
33
Jurgen Van Limmen
34
Piet Wyffels
35
Tom Jacobs
36
Nathalie Roels
37
Ann De Bruyne
38
Stijn van de Velde
39
Brigitte Leva
40
Sandrine Damster
41
Benoit Plichon
42
Marina JurosZovko
43
Dejana Djonovic-Omanoviċ
44
Selma Pernar
45
Josip Zunic
46
Petar Miskovic
47
Antonio Zilic
48
Slavica Kvolik
49
Dubravka Ivic
50
Darija Azenic-Venzera
51
Sonja Skiljic
52
Hrvoje Vinkovic
53
Ivana Oputric
54
Kazimir Juricic
55
Vedran Frkovic
56
Jasminka Kopic
57
Ivan Mirkovic
58
Nenad Karanovic
59
Mladen Carev
60
Natasa Dropulic
61
Jadranka Pavicic Saric
62
Gorjana Erceg
63
Matea Bogdanovic Dvorscak
64
Branka Mazul-Sunko
65
Anna Marija Pavicic
66
Tanja Goranovic
67
Branka Maldini
68
Tomislav Radocaj
69
Zeljka Gavranovic
70
Inga Mladic-Batinica
71
Mirna Sehovic
72
Petr Stourac
73
Hana Harazim
74
Olga Smekalova
75
Martina Kosinova
76
Tomas Kolacek
77
Kamil Hudacek
78
Michal Drab
79
Jan Brujevic
80
Katerina Vitkova
81
Katerina Jirmanova
82
Ivana Volfova
83
Paula Dzurnakova
84
Katarina Liskova
85
Radovan Dudas
86
Radek Filipsky
87
Samir el Kafrawy
88
Hisham Hosny Abdelwahab
89
Tarek Metwally
90
Ahmed Abdel-Razek
91
Ahmed Mostafa El-Shaarawy
92
Wael Fathy Hasan
93
Ahmed Gouda Ahmed
94
Hany Yassin
95
Mohamed Magdy
96
M. Abdelhady
97
M. Mahran
98
E. Herodes
99
P. Kivik
100
J. Oganjan
Anahtar Kelimeler
Anesthesia, intraoperative ventilation
Carbon dioxide
CO 2
End–tidal CO 2
etCO 2
Invasive ventilation
Postoperative pulmonary complications
PPCs
Ventilation
Kurumlar
Amsterdam UMC - University of Amsterdam
Amsterdam Netherlands
Antoni van Leeuwenhoek Ziekenhuis
Amsterdam Netherlands
Austin Hospital
Melbourne Australia
Cleveland Clinic Foundation
Cleveland United States
Helicopter Emergency Medical Service Lifeliner 1
Amsterdam Netherlands
Hospital Israelita Albert Einstein
Sao Paulo Brazil
Mahidol Oxford Tropical Medicine Research Unit
Bangkok Thailand
Medizinische Universität Wien
Vienna Austria
Melbourne Medical School
Melbourne Australia
Monash University
Melbourne Australia
New Cross Hospital
Wolverhampton United Kingdom
Nuffield Department of Medicine
Oxford United Kingdom
Universitätsklinikum Carl Gustav Carus Dresden
Dresden Germany