Search

Your search keyword '"Hemmes, Sabrine N. T."' showing total 149 results
Start Over Author "Hemmes, Sabrine N. T."
149 results on '"Hemmes, Sabrine N. T."'

1. Geo–economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia– posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Published
2022
Full Text
View/download PDF

2. Safety and Feasibility of Intraoperative High PEEP Titrated to the Lowest Driving Pressure (ΔP)—Interim Analysis of DESIGNATION.

Author

Nijbroek, Sunny G. L. H., Hol, Liselotte, Serpa Neto, Ary, van Meenen, David M. P., Hemmes, Sabrine N. T., Hollmann, Markus W., and Schultz, Marcus J.

Subjects
POSITIVE end-expiratory pressure, ARTIFICIAL respiration, ABDOMINAL surgery, GENERAL anesthesia
Abstract

Uncertainty remains about the best level of intraoperative positive end–expiratory pressure (PEEP). An ongoing RCT ('DESIGNATION') compares an 'individualized high PEEP' strategy ('iPEEP')—titrated to the lowest driving pressure (ΔP) with recruitment maneuvers (RM), with a 'standard low PEEP' strategy ('low PEEP')—using 5 cm H2O without RMs with respect to the incidence of postoperative pulmonary complications. This report is an interim analysis of safety and feasibility. From September 2018 to July 2022, we enrolled 743 patients. Data of 698 patients were available for this analysis. Hypotension occurred more often in 'iPEEP' vs. 'low PEEP' (54.7 vs. 44.1%; RR, 1.24 (95% CI 1.07 to 1.44); p < 0.01). Investigators were compliant with the study protocol 285/344 patients (82.8%) in 'iPEEP', and 345/354 patients (97.5%) in 'low PEEP' (p < 0.01). Most frequent protocol violation was missing the final RM at the end of anesthesia before extubation; PEEP titration was performed in 99.4 vs. 0%; PEEP was set correctly in 89.8 vs. 98.9%. Compared to 'low PEEP', the 'iPEEP' group was ventilated with higher PEEP (10.0 (8.0–12.0) vs. 5.0 (5.0–5.0) cm H2O; p < 0.01). Thus, in patients undergoing general anesthesia for open abdominal surgery, an individualized high PEEP ventilation strategy is associated with hypotension. The protocol is feasible and results in clear contrast in PEEP. DESIGNATION is expected to finish in late 2023. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

3. Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT): an international, multicentre, prospective study

Author

Bell, Adam, Gecaj-Gashi, Agreta, Dilek, Ahmet, Denker, Ahmet Sukru, Aytulun, Akut, Kienbaum, Peter, Rose, Alastair, Bacuzzi, Alessandro, Cavalcanti, Alexandre Biasi, Chan, Alexandre, Molin, Alexandre, Ghosh, Alison, Roy, Alistair, Cowton, Amanda, Skinner, Amanda, Whileman, Amanda, McInerney, Amy, Peçanha, Ana Carolina, Cortegiani, Andrea, Sribar, Andrej, Bentley, Andrew, Corner, Andrew, Pinder, Angela, Hormis, Anil, Walker, Anna, Artigas-Raventós, Antonio, Neto, Ary Serpa, Dixon, Barry, Creagh-Brown, Ben, Volta, Carlo Alberto, Munhoz, Carlos, Brown, Carly, Barbas, Carmen S V, Scott, Carmen, Wreybrown, Caroline, Plowright, Catherine, Downes, Charlotte, Padilla-Harris, Cheryl, Hughes, Chloe, Frey, Christian, Putensen, Christian, Schlegel, Christian, Boyd, Christine, Ryan, Christine, Muench, Christoph, Smalley, Christopher, Zincircioglu, Çiler, Harris, Clair, Kaloo, Claire, Matthews, Claire, Miller, Claire, Pegg, Claire, Bullock, Clare, Mellis, Clare, Piras, Claudio, Seasman, Colette, Santos, Cristina, Beraldo, Daniel, Collins, Daniel, Hadfield, Daniel, Hull, Daniel, Prado, Daniel, Pogson, David, Rogerson, David, Shaw, David, D'Antini, Davide, Griffin, Dawn Trodd Denise, Weller, Debbie, Smith, Deborah, Wilson, Deborah, Aydin, Demet, Donaldson, Denise, Mestria, Donatella, Tschernko, Edda M, Lauro, Eduardo Di, Caser, Eliane Bernadete, Seghelini, Elisa, Cirstea, Emanuel, Young, Eoin, Alberts, Erna, Senturk, Evren, Simonis, Fabienne D, Brohi, Farooq, Ulger, Fatma, Kahveci, Feda, da Silva Ramos, Fernando José, Van Haren, Frank, Turan, Güldem, Sales, Gabriele, Mills, Gary H, Clifford, Gayle, Cinnella, Gilda, Mecatti, Giovana Colozza, Melchionda, Giuseppe, Hedenstierna, Goran, Hermans, Greet, Eren, Gulay, Crowther, Hannah, Spencer, Hazel, Blaylock, Heather, Green, Helen, Robertson, Helen, Rodgers, Helen, Talbot, Helen, Wong, Helen, Barcraft-Barnes, Helena, Ceunen, Helga, Reschreiter, Henrik, Wrigge, Hermann, Ulusoy, Hulya, Toman, Huseyin, McCullagh, Iain, White, Ian, Martin-Loeches, Ignacio, Welters, Ingeborg, van den Hul, Ingrid, Gava, Isabela Ambrósio, Reed, Isabelle, Kose, Isil, Maia, Israel, Limb, James, Máca, Jan, Adderly, Jane, Hunt, Jane, Martin, Jane, Montgomery, Jane, Snell, Jane, Canet, Jaume, Salgado, Jean, Ritzema, Jenny, Bewley, Jeremy, Howe, Joanne, Decruyenaere, Johan, Mouland, Johanna, Stickley, Johanna, Mellinghoff, Johannes, Criswell, John, Knighton, John, Cooper, Jonathan, Harrison, Jonathan, Paddle, Jonathan, Pellegrini, Jose Augusto Santos, Needleman, Joseph, Giles, Julian, Camsooksai, Julie, Furneval, Julie, Toms, Julie, Burt, Karen, Simeson, Karen, Williams, Karen, Blenk, Karl, Turner, Kate, Lynch, Katie, Sweet, Katie, Hugill, Keith, Matthews, Kelly, Ruas, Kessia, Clarkson, Kevin, Preller, Kobus, Joyce, Kristen, Ortiz-Ruiz, Laura, Youds, Laura, Tbaily, Lee, Barrell, Lisa, Grimmer, Lisa, Soyoral, Lokman, Peluso, Lorenzo, Murray, Lorna, Niska, Lotta, Tonks, Louise, Fasting, Lousie, DeCrop, Luc, Brazzi, Luca, Mirabella, Lucia, Cooper, Lucy, Falcão, Luis Fernando, Everett, Lynn, Watters, Malcolm, Carnahan, Mandy, Bourgeois, Marc, Abreu, Marcelo Gama de, Romano, Marcelo Luz Pereira, Botteri, Marco, Melo, Marcos F Vidal, Schultz, Marcus J, Faulkner, Maria, Krkusek, Marijana, Bahl, Marina, Holliday, Mark, Kol, Mark, Pulletz, Mark, Hollmann, Markus W, Kozlowski, Marta, Dvorscak, Matea Bogdanovic, Jurjevic, Matija, Koopmans, Matty, Morales, Mauricio, Schaefer, Maximilian, Brazier, Melinda, Harris, Meredith, Devile, Michael, Hiesmayr, Michael, Kuiper, Michael, Parris, Michael, Sharman, Michael, Kratochvil, Milan, Ramali, Mohamed, dos Santos, Moreno Calcagnotto, Bynorth, Natalie, Wilson, Natalie, Anquez, Nathalie, Huneke, Nathan, Dogan, Nazim, Karanovic, Nenad, Tarmey, Nicholas, Carreño, Nicolás, Fisher, Nicola, Lamb, Nicola, Venner, Nicola, Hollister, Nigel, Akgun, Nur, Ekinci, Osman, Boyd, Owen, Pelosi, Paolo, Severgnini, Paolo, Gill, Pardeep, Raimondo, Pasquale, Verrastro, Pasquale, Pulak, Paul, Fitzell, Pauline, Dark, Paulo, Alzugaray, Pedro, Özcan, Perihan Ergin, MacNaughton, Peter, Stourac, Petr, Hopkins, Phil, Tuinman, Pieter Roel, Pearson, Rachel, Walker, Rachel, Santos, Rafaella Souza dos, Caione, Raffaele, Matsa, Ramprasad, Oliver, Rebecca, Jacob, Reni, Howard-Griffin, Richard, Wilde, Robert BP de, Plant, Robert, Hollands, Robin, Biondi, Rodrigo, Smith, Roger, Determann, Rogier M, Jaafar, Rola, Avendaño, Rossana, Pearse, Rupert M, Salt, Ruth, Humphries, Ryan, Pinto, Sérgio Felix, Hemmes, Sabrine N T, Pearson, Sallyane, Hendry, Sam, Jaber, Samir, Lakhani, Sandeep, Beavis, Sarah, Moreton, Sarah, Prudden, Sarah, Thornthwaite, Sarah, Spadaro, Savino, Saylan, Sedat, Chenna, Shailaja, Gopal, Shammer, James, Shanaz, Suresh, Sheeba, Birch, Sian, Skilijic, Sonja, Aguirre, Stefania, Metherell, Stella, Bell, Stephanie, Janes, Stephanie, Wright, Stephen, Rose, Steve, Windebank, Steve, Glenn, Sue, Melbourne, Susan, Tyson, Susan, Leaver, Susannah, Treschan, Tanja A, Patel, Tasmin, Simurina, Tatjana, Sewell, Terri-Ann, Macruz, Tiago, Hatton, Tom, Evans, Tracey, Goktas, Ugur, Poultney, Una, Buyukkocak, Unase, Linnett, Vanessa, Oliveira, Vanessa, Russotto, Vincenzo, Klaric, Vlasta, Schmid, Werner, Orak, Yavuz, Demirtürk, Zerrin, Anstey, James, Melo, Marcos F V, and de Abreu, Marcelo Gama

Published
2016
Full Text
View/download PDF

4. Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data

Author

Neto, Ary Serpa, Hemmes, Sabrine N T, Barbas, Carmen S V, Beiderlinden, Martin, Fernandez-Bustamante, Ana, Futier, Emmanuel, Gajic, Ognjen, El-Tahan, Mohamed R, Ghamdi, Abdulmohsin A Al, Günay, Ersin, Jaber, Samir, Kokulu, Serdar, Kozian, Alf, Licker, Marc, Lin, Wen-Qian, Maslow, Andrew D, Memtsoudis, Stavros G, Miranda, Dinis Reis, Moine, Pierre, Ng, Thomas, Paparella, Domenico, Ranieri, V Marco, Scavonetto, Federica, Schilling, Thomas, Selmo, Gabriele, Severgnini, Paolo, Sprung, Juraj, Sundar, Sugantha, Talmor, Daniel, Treschan, Tanja, Unzueta, Carmen, Weingarten, Toby N, Wolthuis, Esther K, Wrigge, Hermann, Amato, Marcelo B P, Costa, Eduardo L V, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J

Published
2016
Full Text
View/download PDF

7. Potentially modifiable respiratory variables contributing to outcome in ICU patients without ARDS: a secondary analysis of PRoVENT

Author

Simonis, Fabienne D., Barbas, Carmen S. V., Artigas-Raventós, Antonio, Canet, Jaume, Determann, Rogier M., Anstey, James, Hedenstierna, Goran, Hemmes, Sabrine N. T., Hermans, Greet, Hiesmayr, Michael, Hollmann, Markus W., Jaber, Samir, Martin-Loeches, Ignacio, Mills, Gary H., Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Smith, Roger, Treschan, Tanja A., Tschernko, Edda M., Vidal Melo, Marcos F., Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J., Neto, Ary Serpa, For the PRoVENT investigators, and The PROVE Network investigators

Published
2018
Full Text
View/download PDF

8. Additional file 1 of Geo���economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia��� posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 1. Full list of LAS VEGAS collaborators. A list of all LAS VEGAS researchers and their affiliations.

Published
2022
Full Text
View/download PDF

9. Additional file 8 of Geo���economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia��� posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 8. Multivariate model of factors associated with the development of PPC. HIC and UMIC were compared to LMIC and centers were entered as random effect.

Published
2022
Full Text
View/download PDF

10. Additional file 6 of Geo���economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia��� posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Subjects
Astrophysics::Solar and Stellar Astrophysics
Abstract

Additional file 6. Posthoc pairwise analysis for numerical data. Posthoc Dunn���s test for pairwise multiple comparison of the ranked data.

Published
2022
Full Text
View/download PDF

11. Additional file 2 of Geo���economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia��� posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 2. ARISAT score. The ARISCAT risk score is used to calculate the risk for developing postoperative pulmonary complications.

Published
2022
Full Text
View/download PDF

12. Additional file 3 of Geo���economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia��� posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 3. Definitions of postoperative pulmonary complications. A description of the definitions of postoperative pulmonary complications used in this analysis.

Published
2022
Full Text
View/download PDF

13. Additional file 4 of Geo���economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia��� posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 4. Definitions of intraoperative complications. A description of the definitions of intraoperative complications used in this analysis.

Published
2022
Full Text
View/download PDF

14. Additional file 7 of Geo���economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia��� posthoc analysis of an observational study in 29 countries

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 7. Posthoc pairwise analysis for categorical data. Chi-square test for pairwise comparison.

Published
2022
Full Text
View/download PDF

15. Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

Author

Nijbroek, Sunny G, Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N T, Serpa Neto, Ary, Binnekade, Jan M, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J, Wolfgang Kroell, Helfried Metzler, Gerd Struber, Thomas Wegscheider, Hans Gombotz, Michael Hiesmayr, Werner Schmid, Bernhard Urbanek, David Kahn, Mona Momeni, Audrey Pospiech, Fernande Lois, Patrice Forget, Irina Grosu, Jan Poelaert, Veerle van Mossevelde, Marie-Claire van Malderen, Dimitri Dylst, Jeroen van Melkebeek, Maud Beran, Stefan de Hert, Luc De Baerdemaeker, Bjorn Heyse, Jurgen Van Limmen, Piet Wyffels, Tom Jacobs, Nathalie Roels, Ann De Bruyne, Stijn van de Velde, Brigitte Leva, Sandrine Damster, Benoit Plichon, Marina Juros-Zovko, Dejana Djonoviċ- Omanoviċ, Selma Pernar, Josip Zunic, Petar Miskovic, Antonio Zilic, Slavica Kvolik, Dubravka Ivic, Darija Azenic-Venzera, Sonja Skiljic, Hrvoje Vinkovic, Ivana Oputric, Kazimir Juricic, Vedran Frkovic, Jasminka Kopic, Ivan Mirkovic, Nenad Karanovic, Mladen Carev, Natasa Dropulic, Jadranka Pavicic Saric, Gorjana Erceg, Matea Bogdanovic Dvorscak, Branka Mazul-Sunko, Anna Marija Pavicic, Tanja Goranovic, Branka Maldini, Tomislav Radocaj, Zeljka Gavranovic, Inga Mladic-Batinica, Mirna Sehovic, Petr Stourac, Hana Harazim, Olga Smekalova, Martina Kosinova, Tomas Kolacek, Kamil Hudacek, Michal Drab, Jan Brujevic, Katerina Vitkova, Katerina Jirmanova, Ivana Volfova, Paula Dzurnakova, Katarina Liskova, Radovan Dudas, Radek Filipsky, Samir el Kafraw, Hisham Hosny Abdelwahab, Tarek Metwally, Ahmed Abdel-Razek, Ahmed Mostafa El-Shaarawy, Hany Yassin, Mohamed Magdy, Mahdy Abdelhady, Mohamed Mahran, Eiko Herodes, Peeter Kivik, Juri Oganjan, Annika Aun, Alar Sormus, Kaili Sarapuu, Merilin Mall, Juri Karjagin, Emmanuel Futier, Antoine Petit, Adeline Gerard, Emmanuel Marret, Marc Solier, Samir Jaber, Albert Prades, Jens Krassler, Simone Merzky, Marcel Gama de Abreu, Christopher Uhlig, Thomas Kiss, Anette Bundy, Thomas Bluth, Andreas Gueldner, Peter Spieth, Martin Scharffenberg, Denny Tran Thiem, Thea Koch, Tanja Treschan, Maximilian Schaefer, Bea Bastin, Johann Geib, Martin Weiss, Peter Kienbaum, Benedikt Pannen, Andre Gottschalk, Mirja Konrad, Diana Westerheide, Ben Schwerdtfeger, Hermann Wrigge, Philipp Simon, Andreas Reske, Christian Nestler, Dimitrios Valsamidis, Konstantinos Stroumpoulis, Georgios Antholopoulos, Antonis Andreou, Dimitris Karapanos, Kassiani Theodoraki, Georgios Gkiokas, Marios-Konstantinos Tasoulis, Tatiana Sidiropoulou, Foteini Zafeiropoulou, Panagiota Florou, Aggeliki Pandazi, Georgia Tsaousi, Christos Nouris, Chryssa Pourzitaki, Dmitri Bystritski, Reuven Pizov, Arieh Eden, Caterina Valeria Pesce, Annamaria Campanile, Antonella Marrella, Salvatore Grasso, Michele De Michele, Francesco Bona, Gianmarco Giacoletto, Elena Sardo, Luigi Giancarlo, Vicari Sottosanti, Maurizio Solca, Carlo Alberto Volta, Savino Spadaro, Marco Verri, Riccardo Ragazzi, Roberto Zoppellari, Gilda Cinnella, Pasquale Raimondo, Daniela La Bella, Lucia Mirabella, Davide D'antini, Paolo Pelosi, Alexandre Molin, Iole Brunetti, Angelo Gratarola, Giulia Pellerano, Rosanna Sileo, Stefano Pezzatto, Luca Montagnani, Laura Pasin, Giovanni Landoni, Alberto Zangrillo, Luigi Beretta, Ambra Licia Di Parma, Valentina Tarzia, Roberto Dossi, Marta Eugenia Sassone, Daniele Sances, Stefano Tredici, Gianluca Spano, Gianluca Castellani, Luigi Delunas, Sopio Peradze, Marco Venturino, Ines Arpino, Sara Sher, Concezione Tommasino, Francesca Rapido, Paola Morelli, Maria Vargas, Giuseppe Servillo, Andrea Cortegiani, Santi Maurizio Raineri, Francesca Montalto, Vincenzo Russotto, Antonino Giarratano, Marco Baciarello, Michela Generali, Giorgia Cerati, Yigal Leykin, Filippo Bressan, Vittoria Bartolini, Lucia Zamidei, Luca Brazzi, Corrado Liperi, Gabriele Sales, Laura Pistidda, Paolo Severgnini, Elisa Brugnoni, Giuseppe Musella, Alessandro Bacuzzi, Dalip Muhardri, Gecaj-Gashi Agreta, Fatos Sada, Adem Bytyqi, Aurika Karbonskiene, Ruta Aukstakalniene, Zivile Teberaite, Erika Salciute, Renatas Tikuisis, Povilas Miliauskas, Sipylaite Jurate, Egle Kontrimaviciute, Gabija Tomkute, John Xuereb, Maureen Bezzina, Francis Joseph Borg, Sabrine Hemmes, Marcus Schultz, Markus Hollmann, Irene Wiersma, Christa Boer, Anne Duvekot, Bas in ‘t Veld, Alice Werger, Paul Dennesen, Charlotte Severijns, Jasper De Jong, Jens Hering, Rienk van Beek, Stefan Ivars, Ib Jammer, Alena Breidablik, Katharina Skirstad Hodt, Frode Fjellanger, Manuel Vico Avalos, Jannicke Mellin-Olsen, Elisabeth Andersson, Amir Shafi-Kabir, Ruby Molina, Stanley Wutai, Erick Morais, Glória Tareco, Daniel Ferreira, Joana Amaral, Maria de Lurdes, Goncalves Castro, Susana Cadilha, Sofia Appleton, Suzana Parente, Mariana Correia, Diogo Martins, Angela Monteirosa, Ana Ricardo, Sara Rodrigues, Lucian Horhota, Ioana Marina Grintescu, Liliana Mirea, Ioana Cristina Grintescu, Dan Corneci, Silvius Negoita, Madalina Dutu, Ioana Popescu Garotescu, Daniela Filipescu, Alexandru Bogdan Prodan, Gabriela Droc, Ruxandra Fota, Mihai Popescu, Dana Tomescu, Ana Maria Petcu, Marian Irinel Tudoroiu, Alida Moise, Catalin-Traian Guran, Iorel Gherghina, Dan Costea, Iulia Cindea, Sanda-Maria Copotoiu, Ruxandra Copotoiu, Victoria Barsan, Zsolt Tolcser, Magda Riciu, Septimiu Gheorghe Moldovan, Mihaly Veres, Alexey Gritsan, Tatyana Kapkan, Galina Gritsan, Oleg Korolkov, Alexander Kulikov, Andrey Lubnin, Alexey Ovezov, Pavel Prokoshev, Alexander Lugovoy, Natalia Anipchenko, Andrey Babayants, Irina Komissarova, Karginova Zalina, Valery Likhvantsev, Sergei Fedorov, Aleksandra Lazukic, Jasmina Pejakovic, Dunja Mihajlovic, Zuzana Kusnierikova, Maria Zelinkova, Katarina Bruncakova, Lenka Polakovicova, Villiam Sobona, Barbka Novak-Supe, Ana Pekle-Golez, Miroljub Jovanov, Branka Strazisar, Jasmina Markovic-Bozi, Vesna Novak-Jankovic, Minca Voje, Andriy Grynyuk, Ivan Kostadinov, Alenka Spindler-Vesel, Victoria Moral, Mari Carmen Unzueta, Carlos Puigbo, Josep Fava, Jaume Canet, Enrique Moret, Mónica Rodriguez Nunez, Mar Sendra, Andrea Brunelli, Frederic Rodenas, Pablo Monedero, Francisco Hidalgo Martinez, Maria Jose Yepes Temino, Antonio Martínez Simon, Ana de Abajo Larriba, Alberto Lisi, Gisela Perez, Raquel Martinez, Manuel Granell, Jose Tatay Vivo, Cristina Saiz Ruiz, Jose Antonio de Andrés Ibañez, Ernesto Pastor, Marina Soro, Carlos Ferrando, Mario Defez, Cesar Aldecoa Alvares-Santullano, Rocio Perez, Jesus Rico, Monir Jawad, Yousif Saeed, Lars Gillberg, Zuleyha Kazak Bengisun, Baturay Kansu Kazbek, Nesil Coskunfirat, Neval Boztug, Suat Sanli, Murat Yilmaz, Necmiye Hadimioglu, Nuzhet Mert Senturk, Emre Camci, Semra Kucukgoncu, Zerrin Sungur, Nukhet Sivrikoz, Serpil Ustalar Ozgen, Fevzi Toraman, Onur Selvi, Ozgur Senturk, Mine Yildiz, Bahar Kuvaki, Ferim Gunenc, Semih Kucukguclu, Şule Ozbilgin, Jale Maral, Seyda Canli, Oguzhan Arun, Ali Saltali, Eyup Aydogan, Fatma Nur Akgun, Ceren Sanlikarip, Fatma Mine Karaman, Andriy Mazur, Sergiy Vorotyntsev, Guy Rousseau, Colin Barrett, Lucia Stancombe, Ben Shelley, Helen Scholes, James Limb, Amir Rafi, Lisa Wayman, Jill Deane, David Rogerson, John Williams, Susan Yates, Elaine Rogers, Mark Pulletz, Sarah Moreton, Stephanie Jones, Suresh Venkatesh, Maudrian Burton, Lucy Brown, Cait Goodall, Matthew Rucklidge, Debbie Fuller, Maria Nadolski, Sandeep Kusre, Michael Lundberg, Lynn Everett, Maka Zuleika, Peter Carvalho, Deborah Clements, Ben Creagh-Brown, Philip Watt, Parizade Raymode, Rupert Pearse, Otto Mohr, Ashok Raj, Thais Creary, Ahmed Chishti, Andrea Bell, Charley Higham, Alistair Cain, Sarah Gibb, Stephen Mowat, Danielle Franklin, Claire West, Gary Minto, Nicholas Boyd, Gary Mills, Emily Calton, Rachel Walker, Felicity Mackenzie, Branwen Ellison, Helen Roberts, Moses Chikungwa, Clare Jackson, Andrew Donovan, Jayne Foot, Elizabeth Homan, Jane Montgomery, David Portch, Pauline Mercer, Janet Palmer, Jonathan Paddle, Anna Fouracres, Amanda Datson, Alyson Andrew, Leanne Welch, Alastair Rose, Sandeep Varma, Karen Simeson, Mrutyunjaya Rambhatla, Jaysimha Susarla, Sudhakar Marri, Krishnan Kodaganallur, Ashok Das, Shivarajan Algarsamy, Julie Colley, Simon Davies, Margaret Szewczyk, Thomas Smith, Ana Fernandez- Bustamante, Elizabeth Luzier, Angela Almagro, Marcos Vidal Melo, Luiz Fernando, Demet Sulemanji, Juraj Sprung, Toby Weingarten, Daryl Kor, Federica Scavonetto, Yeo Tze, Nijbroek, Sunny G, Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N T, Serpa Neto, Ary, Binnekade, Jan M, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J,Wolfgang Kroell, Helfried Metzler, Gerd Struber, Thomas Wegscheider, Hans Gombotz, Michael Hiesmayr, Werner Schmid, Bernhard Urbanek, David Kahn, Mona Momeni, Audrey Pospiech, Fernande Lois, Patrice Forget, Irina Grosu, Jan Poelaert, Veerle van Mossevelde, Marie-Claire van Malderen, Dimitri Dylst, Jeroen van Melkebeek, Maud Beran, Stefan de Hert, Luc De Baerdemaeker, Bjorn Heyse, Jurgen Van Limmen, Piet Wyffels, Tom Jacobs, Nathalie Roels, Ann De Bruyne, Stijn van de Velde, Brigitte Leva, Sandrine Damster, Benoit Plichon, Marina Juros-Zovko, Dejana Djonoviċ- Omanoviċ, Selma Pernar, Josip Zunic, Petar Miskovic, Antonio Zilic, Slavica Kvolik, Dubravka Ivic, Darija Azenic-Venzera, Sonja Skiljic, Hrvoje Vinkovic, Ivana Oputric, Kazimir Juricic, Vedran Frkovic, Jasminka Kopic, Ivan Mirkovic, Nenad Karanovic, Mladen Carev, Natasa Dropulic, Jadranka Pavicic Saric, Gorjana Erceg, Matea Bogdanovic Dvorscak, Branka Mazul-Sunko, Anna Marija Pavicic, Tanja Goranovic, Branka Maldini, Tomislav Radocaj, Zeljka Gavranovic, Inga Mladic-Batinica, Mirna Sehovic, Petr Stourac, Hana Harazim, Olga Smekalova, Martina Kosinova, Tomas Kolacek, Kamil Hudacek, Michal Drab, Jan Brujevic, Katerina Vitkova, Katerina Jirmanova, Ivana Volfova, Paula Dzurnakova, Katarina Liskova, Radovan Dudas, Radek Filipsky, Samir el Kafraw, Hisham Hosny Abdelwahab, Tarek Metwally, Ahmed Abdel-Razek, Ahmed Mostafa El-Shaarawy, Hany Yassin, Mohamed Magdy, Mahdy Abdelhady, Mohamed Mahran, Eiko Herodes, Peeter Kivik, Juri Oganjan, Annika Aun, Alar Sormus, Kaili Sarapuu, Merilin Mall, Juri Karjagin, Emmanuel Futier, Antoine Petit, Adeline Gerard, Emmanuel Marret, Marc Solier, Samir Jaber, Albert Prades, Jens Krassler, Simone Merzky, Marcel Gama de Abreu, Christopher Uhlig, Thomas Kiss, Anette Bundy, Thomas Bluth, Andreas Gueldner, Peter Spieth, Martin Scharffenberg, Denny Tran Thiem, Thea Koch, Tanja Treschan, Maximilian Schaefer, Bea Bastin, Johann Geib, Martin Weiss, Peter Kienbaum, Benedikt Pannen, Andre Gottschalk, Mirja Konrad, Diana Westerheide, Ben Schwerdtfeger, Hermann Wrigge, Philipp Simon, Andreas Reske, Christian Nestler, Dimitrios Valsamidis, Konstantinos Stroumpoulis, Georgios Antholopoulos, Antonis Andreou, Dimitris Karapanos, Kassiani Theodoraki, Georgios Gkiokas, Marios-Konstantinos Tasoulis, Tatiana Sidiropoulou, Foteini Zafeiropoulou, Panagiota Florou, Aggeliki Pandazi, Georgia Tsaousi, Christos Nouris, Chryssa Pourzitaki, Dmitri Bystritski, Reuven Pizov, Arieh Eden, Caterina Valeria Pesce, Annamaria Campanile, Antonella Marrella, Salvatore Grasso, Michele De Michele, Francesco Bona, Gianmarco Giacoletto, Elena Sardo, Luigi Giancarlo, Vicari Sottosanti, Maurizio Solca, Carlo Alberto Volta, Savino Spadaro, Marco Verri, Riccardo Ragazzi, Roberto Zoppellari, Gilda Cinnella, Pasquale Raimondo, Daniela La Bella, Lucia Mirabella, Davide D'antini, Paolo Pelosi, Alexandre Molin, Iole Brunetti, Angelo Gratarola, Giulia Pellerano, Rosanna Sileo, Stefano Pezzatto, Luca Montagnani, Laura Pasin, Giovanni Landoni, Alberto Zangrillo, Luigi Beretta, Ambra Licia Di Parma, Valentina Tarzia, Roberto Dossi, Marta Eugenia Sassone, Daniele Sances, Stefano Tredici, Gianluca Spano, Gianluca Castellani, Luigi Delunas, Sopio Peradze, Marco Venturino, Ines Arpino, Sara Sher, Concezione Tommasino, Francesca Rapido, Paola Morelli, Maria Vargas, Giuseppe Servillo, Andrea Cortegiani, Santi Maurizio Raineri, Francesca Montalto, Vincenzo Russotto, Antonino Giarratano, Marco Baciarello, Michela Generali, Giorgia Cerati, Yigal Leykin, Filippo Bressan, Vittoria Bartolini, Lucia Zamidei, Luca Brazzi, Corrado Liperi, Gabriele Sales, Laura Pistidda, Paolo Severgnini, Elisa Brugnoni, Giuseppe Musella, Alessandro Bacuzzi, Dalip Muhardri, Gecaj-Gashi Agreta, Fatos Sada, Adem Bytyqi, Aurika Karbonskiene, Ruta Aukstakalniene, Zivile Teberaite, Erika Salciute, Renatas Tikuisis, Povilas Miliauskas, Sipylaite Jurate, Egle Kontrimaviciute, Gabija Tomkute, John Xuereb, Maureen Bezzina, Francis Joseph Borg, Sabrine Hemmes, Marcus Schultz, Markus Hollmann, Irene Wiersma, Christa Boer, Anne Duvekot, Bas in ‘t Veld, Alice Werger, Paul Dennesen, Charlotte Severijns, Jasper De Jong, Jens Hering, Rienk van Beek, Stefan Ivars, Ib Jammer, Alena Breidablik, Katharina Skirstad Hodt, Frode Fjellanger, Manuel Vico Avalos, Jannicke Mellin-Olsen, Elisabeth Andersson, Amir Shafi-Kabir, Ruby Molina, Stanley Wutai, Erick Morais, Glória Tareco, Daniel Ferreira, Joana Amaral, Maria de Lurdes, Goncalves Castro, Susana Cadilha, Sofia Appleton, Suzana Parente, Mariana Correia, Diogo Martins, Angela Monteirosa, Ana Ricardo, Sara Rodrigues, Lucian Horhota, Ioana Marina Grintescu, Liliana Mirea, Ioana Cristina Grintescu, Dan Corneci, Silvius Negoita, Madalina Dutu, Ioana Popescu Garotescu, Daniela Filipescu, Alexandru Bogdan Prodan, Gabriela Droc, Ruxandra Fota, Mihai Popescu, Dana Tomescu, Ana Maria Petcu, Marian Irinel Tudoroiu, Alida Moise, Catalin-Traian Guran, Iorel Gherghina, Dan Costea, Iulia Cindea, Sanda-Maria Copotoiu, Ruxandra Copotoiu, Victoria Barsan, Zsolt Tolcser, Magda Riciu, Septimiu Gheorghe Moldovan, Mihaly Veres, Alexey Gritsan, Tatyana Kapkan, Galina Gritsan, Oleg Korolkov, Alexander Kulikov, Andrey Lubnin, Alexey Ovezov, Pavel Prokoshev, Alexander Lugovoy, Natalia Anipchenko, Andrey Babayants, Irina Komissarova, Karginova Zalina, Valery Likhvantsev, Sergei Fedorov, Aleksandra Lazukic, Jasmina Pejakovic, Dunja Mihajlovic, Zuzana Kusnierikova, Maria Zelinkova, Katarina Bruncakova, Lenka Polakovicova, Villiam Sobona, Barbka Novak-Supe, Ana Pekle-Golez, Miroljub Jovanov, Branka Strazisar, Jasmina Markovic-Bozi, Vesna Novak-Jankovic, Minca Voje, Andriy Grynyuk, Ivan Kostadinov, Alenka Spindler-Vesel, Victoria Moral, Mari Carmen Unzueta, Carlos Puigbo, Josep Fava, Jaume Canet, Enrique Moret, Mónica Rodriguez Nunez, Mar Sendra, Andrea Brunelli, Frederic Rodenas, Pablo Monedero, Francisco Hidalgo Martinez, Maria Jose Yepes Temino, Antonio Martínez Simon, Ana de Abajo Larriba, Alberto Lisi, Gisela Perez, Raquel Martinez, Manuel Granell, Jose Tatay Vivo, Cristina Saiz Ruiz, Jose Antonio de Andrés Ibañez, Ernesto Pastor, Marina Soro, Carlos Ferrando, Mario Defez, Cesar Aldecoa Alvares-Santullano, Rocio Perez, Jesus Rico, Monir Jawad, Yousif Saeed, Lars Gillberg, Zuleyha Kazak Bengisun, Baturay Kansu Kazbek, Nesil Coskunfirat, Neval Boztug, Suat Sanli, Murat Yilmaz, Necmiye Hadimioglu, Nuzhet Mert Senturk, Emre Camci, Semra Kucukgoncu, Zerrin Sungur, Nukhet Sivrikoz, Serpil Ustalar Ozgen, Fevzi Toraman, Onur Selvi, Ozgur Senturk, Mine Yildiz, Bahar Kuvaki, Ferim Gunenc, Semih Kucukguclu, Şule Ozbilgin, Jale Maral, Seyda Canli, Oguzhan Arun, Ali Saltali, Eyup Aydogan, Fatma Nur Akgun, Ceren Sanlikarip, Fatma Mine Karaman, Andriy Mazur, Sergiy Vorotyntsev, Guy Rousseau, Colin Barrett, Lucia Stancombe, Ben Shelley, Helen Scholes, James Limb, Amir Rafi, Lisa Wayman, Jill Deane, David Rogerson, John Williams, Susan Yates, Elaine Rogers, Mark Pulletz, Sarah Moreton, Stephanie Jones, Suresh Venkatesh, Maudrian Burton, Lucy Brown, Cait Goodall, Matthew Rucklidge, Debbie Fuller, Maria Nadolski, Sandeep Kusre, Michael Lundberg, Lynn Everett, Maka Zuleika, Peter Carvalho, Deborah Clements, Ben Creagh-Brown, Philip Watt, Parizade Raymode, Rupert Pearse, Otto Mohr, Ashok Raj, Thais Creary, Ahmed Chishti, Andrea Bell, Charley Higham, Alistair Cain, Sarah Gibb, Stephen Mowat, Danielle Franklin, Claire West, Gary Minto, Nicholas Boyd, Gary Mills, Emily Calton, Rachel Walker, Felicity Mackenzie, Branwen Ellison, Helen Roberts, Moses Chikungwa, Clare Jackson, Andrew Donovan, Jayne Foot, Elizabeth Homan, Jane Montgomery, David Portch, Pauline Mercer, Janet Palmer, Jonathan Paddle, Anna Fouracres, Amanda Datson, Alyson Andrew, Leanne Welch, Alastair Rose, Sandeep Varma, Karen Simeson, Mrutyunjaya Rambhatla, Jaysimha Susarla, Sudhakar Marri, Krishnan Kodaganallur, Ashok Das, Shivarajan Algarsamy, Julie Colley, Simon Davies, Margaret Szewczyk, Thomas Smith, Ana Fernandez- Bustamante, Elizabeth Luzier, Angela Almagro, Marcos Vidal Melo, Luiz Fernando, Demet Sulemanji, Juraj Sprung, Toby Weingarten, Daryl Kor, Federica Scavonetto, Yeo Tze, Schultz, Marcus, J, Servillo, G, Vargas, M, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Anesthesiology research group, Supporting clinical sciences, Anesthesiology, Graduate School, AII - Amsterdam institute for Infection and Immunity, Intensive Care Medicine, AII - Inflammatory diseases, ACS - Heart failure & arrhythmias, APH - Quality of Care, ACS - Pulmonary hypertension & thrombosis, APH - Global Health, ACS - Diabetes & metabolism, ACS - Microcirculation, Marcus, J (LAS VEGAS study investigator, the PROVE Network and the Clinical Trial Network of the European Society of, Anaesthesiology), Zangrillo, A, Beretta, L, and Landoni, G

Subjects
Adult, Male, medicine.medical_specialty, Intra operative, health care facilities, manpower, and services, [SDV]Life Sciences [q-bio], Critical Illness, Las Vegas Study, Article, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Internal medicine, Tidal Volume, medicine, Humans, General anaesthesia, Lung, Tidal volume, Female, Respiration, Artificial, Sex Characteristics, Las vegas, business.industry, Respiration, respiratory failure, sex, respiratory system, Sex difference, respiratory tract diseases, Anesthesiology and Pain Medicine, 030228 respiratory system, Relative risk, Artificial, Cohort, Breathing, Observational study, business, intra-operative tidal volume, circulatory and respiratory physiology
Abstract

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (V(T)). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as V(T) of 8 ml kg(−1) or less predicted bodyweight (PBW). A V(T) was deemed ‘default’ if the set V(T) was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default V(T) was often set, both in women and men; mode V(T) was 500 ml. Median [IQR] V(T) was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg(−1) PBW, P*** < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P*** < 0.001]. In the mediation analysis, patients’ height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default V(T). CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher V(T) than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV. TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Published
2021
Full Text
View/download PDF

16. Additional file 1 of The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

Author

Mazzinari, Guido, Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Melo, Marcos F. Vidal, Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Cambronero, Oscar Diaz, Ball, Lorenzo, Abreu, Marcelo Gama De, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 1: Table 1. Patient and surgery related characteristics. Table 2. Intraoperative venitlatory setting by group.

Published
2021
Full Text
View/download PDF

17. Additional file 2 of The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

Author

Mazzinari, Guido, Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Melo, Marcos F. Vidal, Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Cambronero, Oscar Diaz, Ball, Lorenzo, Abreu, Marcelo Gama De, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Additional file 2: Table S1. Definition of postoperative pulmonary complications. Table S2. Definition of intraoperative complications. Table S3. Number of data available at each time point. Table S4. Patients demographics and surgery–related characteristics in the matched cohort for type of surgery. Table S5. Intraoperative and postoperative outcomes in matched cohort for type of surgery. Table S6. Mixed multivariable logistic regression in matched cohort for postoperative pulmonary complications. Figure S1. Time weighted average and coefficient of variation calculation. Figure S2. Summary plot of covariate balance for time-weighted ΔP before (red line) and after (blue line) conditioning for open surgery. Figure S3. Summary plot of covariate balance before (red line) and after (blue line) conditioning for closed surgery. A: time–weighted; B: Highest value; C: Lowest Value; D: Coefficient of variation. Figure S4. Residuals plot for postoperative pulmonary complications (PPCs) and intraoperative adverse events (AEs). A: PPCs in Open surgery; B: PPCs in closed surgery; C; AEs in open surgery; D: AEs in closed surgery.

Published
2021
Full Text
View/download PDF

18. The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study

Author

Mazzinari, Guido, Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Melo, Marcos F. Vidal, Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Cambronero, Oscar Diaz, Ball, Lorenzo, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J., Mazzinari, Guido, Neto, Ary Serpa, Hemmes, Sabrine N. T., Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Melo, Marcos F. Vidal, Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Cambronero, Oscar Diaz, Ball, Lorenzo, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

BackgroundIt is uncertain whether the association of the intraoperative driving pressure (Delta P) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time-weighted average Delta P (Delta P-TW) with PPCs. We also tested the association of Delta P-TW with intraoperative adverse events.MethodsPosthoc retrospective propensity score-weighted cohort analysis of patients undergoing open or closed abdominal surgery in the 'Local ASsessment of Ventilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events.ResultsThe analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. Delta P was lower in open abdominal surgery patients, but Delta P-TW was not different between groups. The association of Delta P-TW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P < 0.001 versus 1.05 [95%CI 1.05 to 1.05], P < 0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P < 0.001). The association of P-TW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12- to 1.14], P < 0.001 versus 1.07 [95%CI 1.05 to 1.10], P < 0.001; risk difference 0.05 [95%CI 0.030.07], P < 0.001).ConclusionsP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery.Trial registrationLAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).

Published
2021
Full Text
View/download PDF

19. The effects of preoperative moderate to severe anaemia on length of hospital stay : A propensity score-matched analysis in non-cardiac surgery patients

Author

Bulte, Carolien S. E., Boer, Christa, Hemmes, Sabrine N. T., Serpa Neto, Ary, Binnekade, Jan M., Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J., Bulte, Carolien S. E., Boer, Christa, Hemmes, Sabrine N. T., Serpa Neto, Ary, Binnekade, Jan M., Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

BACKGROUND Anaemia is frequently recorded during preoperative screening and has been suggested to affect outcomes after surgery negatively. OBJECTIVES The objectives were to assess the frequency of moderate to severe anaemia and its association with length of hospital stay. DESIGN Post hoc analysis of the international observational prospective ‘Local ASsessment of VEntilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study. PATIENTS AND SETTING The current analysis included adult patients requiring general anaesthesia for non-cardiac surgery. Preoperative anaemia was defined as a haemoglobin concentration of 11 g dl−1 or lower, thus including moderate and severe anaemia according to World Health Organisation criteria. MAIN OUTCOME MEASURES The primary outcome was length of hospital stay. Secondary outcomes included hospital mortality, intra-operative adverse events and postoperative pulmonary complications (PPCs). RESULTS Haemoglobin concentrations were available for 8264 of 9864 patients. Preoperative moderate to severe anaemia was present in 7.7% of patients. Multivariable analysis showed that preoperative moderate to severe anaemia was associated with an increased length of hospital stay with a mean difference of 1.3 ((95% CI 0.8 to 1.8) days; P < .001). In the propensity-matched analysis, this association remained present, median 4.0 [IQR 1.0 to 5.0] vs. 2.0 [IQR 0.0 to 5.0] days, P = .001. Multivariable analysis showed an increased in-hospital mortality (OR 2.9 (95% CI 1.1 to 7.5); P = .029), and higher incidences of intra-operative hypotension (36.3 vs. 25.3%; P < .001) and PPCs (17.1 vs. 10.5%; P = .001) in moderately to severely anaemic patients. However, this was not confirmed in the propensity score-matched analysis. CONCLUSIONS In this international cohort of non-cardiac surgical patients, preoperative moderate to severe anaemia was associated with a longer duration of hospital stay but not increased intra-operative comp

Published
2021
Full Text
View/download PDF

20. Sex difference and intra-operative tidal volume : Insights from the LAS VEGAS study

Author

Nijbroek, Sunny G., Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N. T., Serpa Neto, Ary, Binnekade, Jan M., Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J., Nijbroek, Sunny G., Hol, Liselotte, Swart, Pien, Hemmes, Sabrine N. T., Serpa Neto, Ary, Binnekade, Jan M., Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

BACKGROUND One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg−1 or less predicted bodyweight (PBW). A VT was deemed ‘default’ if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation. RESULTS This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg−1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients’ height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT. CONCLUSION In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV. TRIAL REGISTRATION The study was registered at Clinicaltrials.gov, NCT01601223

Published
2021
Full Text
View/download PDF

21. Driving Pressure During General Anesthesia for Open Abdominal Surgery (DESIGNATION): study protocol of a randomized clinical trial

Author

Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, de Abreu, Marcelo Gama, Pelosi, Paolo, Hemmes, Sabrine N. T., Aarts, Leon P. H. J., Akkerman, Ronald D. L., Albersen, Juliette J. E., Aurilio, Caterina, Battaglini, Denise, de Boer, Hans D., Boom, Annemieke, Boer, Christa, Brouwer, Tammo, Buhre, Wolfgang F. F. A., Bulte, Carolina S. E., Edward-Rutten, Gitara M., Godfried, Marc B., Helmerhorst, Hendrik J. F., Hofland, Jan, Hoogenboom, Hester, Ten Hoope, W., Houweling, Bernard M., Huhn, Ragnar, Konijn, Wanda, Koopman-van Gemert, Ankie W. M. M., De Korte-de Boer, Dianne J., Kortekaas, Minke C., Van Lier, Felix, Preckel, Benedikt, Rad, Mandana, Sansone, Pasquale, Stamkot, Andre, Stolker, Robert Jan, Thiel, Bram, Ubben, Johannes F. H., Struys, Michel, In 't Veld, Bastiaan A., Wrigge, Hermann, Zeillemaker-Hoekstra, Miriam, van der Zwan, Tim, Zwijsen, Johannes H. M. J., Hollmann, Markus W., Schultz, Marcus J., Anesthesiology, ACS - Diabetes & metabolism, Hol, L, Nijbroek, Sglh, Neto, A, de Abreu, Mg, Pelosi, P, Hemmes, Snt, Aarts, Lphj, Akkerman, Rdl, Albersen, Jje, Aurilio, C, Battaglini, D, de Boer, Hd, Boom, A, Boer, C, Brouwer, T, Buhre, Wffa, Bulte, Cse, Edward-Rutten, Gm, Godfried, Mb, Helmerhorst, Hjf, Hofland, J, Hoogenboom, H, Ten Hoope, W, Houweling, Bm, Huhn, R, Konijn, W, Koopman-van Gemert, Awmm, De Korte-de Boer, Dj, Kortekaas, Mc, van Lier, F, Preckel, B, Rad, M, Sansone, P, Stamkot, A, Stolker, Rj, Thiel, B, Ubben, Jfh, Struys, Mmrf, 't Veld, Bai, Wrigge, H, Zeillemaker-Hoekstra, M, van der Zwan, T, Zwijsen, Jhmj, Hollmann, Mw, Schultz, Mj, MUMC+: Centrum voor Acute en Kritieke Zorg (3), Anesthesiologie, MUMC+: MA Anesthesiologie (9), RS: MHeNs - R3 - Neuroscience, Graduate School, Intensive Care Medicine, APH - Quality of Care, ACS - Heart failure & arrhythmias, ACS - Pulmonary hypertension & thrombosis, ACS - Microcirculation, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Radiotherapy, Intensive Care, and Cardiology

Subjects
Lung Diseases, Male, ATELECTASIS, medicine.medical_treatment, Medicine (miscellaneous), Atelectasis, Intraoperative ventilation, law.invention, Positive-Pressure Respiration, DEFINITIONS, Study Protocol, 0302 clinical medicine, Mechanical ventilation, Randomized controlled trial, 030202 anesthesiology, law, OBESE-PATIENTS, Clinical endpoint, Medicine and Health Sciences, Medicine, Pharmacology (medical), END-EXPIRATORY-PRESSURE, 030212 general & internal medicine, Tidal volume, Postoperative pulmonary, Randomized Controlled Trials as Topic, Aged, 80 and over, lcsh:R5-920, Postoperative pulmonary complications, Delta P, Positive end-expiratory pressure, Abdominal Cavity, Pulmonary, Middle Aged, respiratory system, Treatment Outcome, Recruitment maneuver, Anesthesia, Surgical Procedures, Operative, Breathing, Female, lcsh:Medicine (General), therapeutics, Compliance, circulatory and respiratory physiology, Adult, Pulmonary complication, ΔP, complications, Anesthesia, General, 03 medical and health sciences, Young Adult, Postoperative complications, Double-Blind Method, Tidal Volume, Humans, LOW-TIDAL-VOLUME, Aged, POSTOPERATIVE PULMONARY COMPLICATIONS, business.industry, CHEST-WALL MECHANICS, medicine.disease, PREVENTION, Postoperative complication, PROTECTIVE MECHANICAL VENTILATION, respiratory tract diseases, Pulmonary complications, business, Postoperative pulmonary complication, LUNG, Abdominal surgery
Abstract

BackgroundIntraoperative driving pressure (ΔP) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (VT) is kept constant, ΔP may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. ΔP may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery.MethodsThe “Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial” (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged ≥ 18 years and with a body mass index ≤ 40 kg/m2, scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) (“individualized high PEEP”) or one in which PEEP of 5 cm H2O without RM is used (“low PEEP”). In the “individualized high PEEP” group, PEEP is set at the level at which ΔP is lowest. In both groups of the trial, VTis kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events.DiscussionDESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery.Trial registrationClinicaltrials.gov,NCT03884543. Registered on 21 March 2019.

Published
2020
Full Text
View/download PDF

22. Additional file 1 of Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study

Author

Robba, Chiara, Hemmes, Sabrine N. T., Neto, Ary Serpa, Bluth, Thomas, Canet, Jaume, Hiesmayr, Michael, M. Wiersma Hollmann, Mills, Gary H., Melo, Marcos F. Vidal, Putensen, Christian, Jaber, Samir, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Battaglini, Denise, Ball, Lorenzo, Abreu, Marcelo Gama De, Schultz, Marcus J., and Pelosi, Paolo

Subjects
Data_FILES
Abstract

Additional file 1.

Published
2020
Full Text
View/download PDF

23. Individualized versus Fixed Positive End-expiratory Pressure for Intraoperative Mechanical Ventilation in Obese Patients: A Secondary Analysis.

Author

Simon, Philipp, Girrbach, Felix, Petroff, David, Schliewe, Nadja, Hempel, Gunther, Lange, Mirko, Bluth, Thomas, Gama de Abreu, Marcelo, Beda, Alessandro, Schultz, Marcus J., Pelosi, Paolo, Reske, Andreas W., Wrigge, Hermann, Bobek, Ilona, Canet, Jaume C., Baerdemaeker, Luc De, Gregoretti, Cesare, Hedenstierna, Göran, Hemmes, Sabrine N. T., and Hiesmayr, Michael

Published
2021
Full Text
View/download PDF

24. International multicenter observational study on assessment of ventilatory management during general anaesthesia for robotic surgery and its effects on postoperative pulmonary complication (AVATaR): study protocol and statistical analysis plan

Author

Queiroz, Veronica Neves Fialho, Da Costa, Luiz Guilherme Villares, Barbosa, Rogerio Póvoa, Takaoka, Flávio, De Baerdemaeker, Luc, Cesar, Daniel Souza, D'Orto, Ulisses Cardoso, Galdi, José Roberto, Gottumukkala, Vijaya, Cata, Juan P, Hemmes, Sabrine N T, Hollman, Markus W, Kalmar, Alain, De Moura, Lucas A B, Mariano, Renato M, Matot, Idit, Mazzinari, Guido, Mills, Gary H, Posso, Irimar De Paula, Teruya, Alexandre, Vidal Melo, Marcos Francisco, Sprung, Juraj, Weingarten, Toby N, Treschan, Tanja A, Koopman, Seppe, Eidelman, Leonid, Chen, Lee-Lynn, Lee, Jae-Woo, Ariño Irujo, Jose J, Tena, Beatriz, Groeben, Harald, Pelosi, Paolo, De Abreu, Marcelo Gama, Schultz, Marcus J, Neto, Ary Serpa, Catala, Juan, Bravo, Mauro, De Freitas, Renato Carneir, Felipe, Chaves, Bruno, Rothman, Arantes, Schuind, Hatanaka, Dina Mie, Beltran, Joan, Monsalve, Concepción, Droger, Sijgje Mari, Deljou, Atousa, Sabov, Moldovan, Rabbu, Yosef Sale, Del Barrio De Bonis, Marina, Babian, Renate, Rabenalt, Robert, Köhne, Wiebke, Ronen, Ariel, Agarwala, Aalok V., Granell, Manuel, Anesthesiology, Intensive Care Medicine, Graduate School, ACS - Diabetes & metabolism, ACS - Pulmonary hypertension & thrombosis, and ACS - Microcirculation

Subjects
Lung Diseases, Laparoscopic surgery, medicine.medical_specialty, PROSTATECTOMY, medicine.medical_treatment, Trendelenburg position, LAPAROSCOPIC SURGERY, Anesthesia, General, mechanical ventilation, general anesthesia, postoperative pulmonary complications, robotic surgery, Medicine (all), Anaesthesia, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Robotic Surgical Procedures, 030202 anesthesiology, Protocol, medicine, Medicine and Health Sciences, Humans, Multicenter Studies as Topic, Robotic surgery, General anaesthesia, 030212 general & internal medicine, Mechanical ventilation, Prostatectomy, business.industry, General surgery, General Medicine, Institutional review board, Respiration, Artificial, body regions, Observational Studies as Topic, Observational study, business
Abstract

IntroductionRobotic-assisted surgery (RAS) has emerged as an alternative minimally invasive surgical option. Despite its growing applicability, the frequent need for pneumoperitoneum and Trendelenburg position could significantly affect respiratory mechanics during RAS. AVATaR is an international multicenter observational study aiming to assess the incidence of postoperative pulmonary complications (PPC), to characterise current practices of mechanical ventilation (MV) and to evaluate a possible association between ventilatory parameters and PPC in patients undergoing RAS.Methods and analysisAVATaR is an observational study of surgical patients undergoing MV for general anaesthesia for RAS. The primary outcome is the incidence of PPC during the first five postoperative days. Secondary outcomes include practice of MV, effect of surgical positioning on MV, effect of MV on clinical outcome and intraoperative complications.Ethics and disseminationThis study was approved by the Institutional Review Board of the Hospital Israelita Albert Einstein. The study results will be published in peer-reviewed journals and disseminated at international conferences.Trial registration numberNCT02989415; Pre-results.

Published
2018

25. The LAS VEGAS risk score for prediction of postoperative pulmonary complications : An observational study

Author

Neto, Ary Serpa, da Costa, Luiz Guilherme V, Hemmes, Sabrine N T, Canet, Jaume, Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J, Neto, Ary Serpa, da Costa, Luiz Guilherme V, Hemmes, Sabrine N T, Canet, Jaume, Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W, Mills, Gary H, Vidal Melo, Marcos F, Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Gama de Abreu, Marcelo, Pelosi, Paolo, and Schultz, Marcus J

Abstract

BACKGROUND: Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE: We aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data. DESIGN: This is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study. SETTINGS: A total of 146 hospitals across 29 countries. PATIENTS: Adult patients requiring intra-operative ventilation during general anaesthesia for surgery. INTERVENTIONS: The cohort was randomly divided into a development subsample to construct a predictive model, and a subsample for validation. MAIN OUTCOME MEASURES: Prediction performance of developed models for PPCs. RESULTS: Of the 6063 patients analysed, 10.9% developed at least one PPC. Regression modelling identified 13 independent risk factors for PPCs: six patient characteristics [higher age, higher American Society of Anesthesiology (ASA) physical score, pre-operative anaemia, pre-operative lower SpO2 and a history of active cancer or obstructive sleep apnoea], two procedure-related features (urgent or emergency surgery and surgery lasting ≥ 1 h), and five intra-operative events [use of an airway other than a supraglottic device, the use of intravenous anaesthetic agents along with volatile agents (balanced anaesthesia), intra-operative desaturation, higher levels of positive end-expiratory pressures > 3 cmH2O and use of vasopressors]. The area under the receiver operating characteristic curve of the LAS VEGAS risk score for prediction of PPCs was 0.78 [95% confidence interval (95% CI), 0.76 to 0.80] for the development subsample and 0.72 (95% CI, 0.69 to 0.76) for the validation subsample. CONCLUSION: The LAS VEGAS risk score including 13 peri-operative characteristics has a moderate discriminative ability for predict

Published
2018
Full Text
View/download PDF

26. Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications:LAS VEGAS - An observational study in 29 countries

Author

Schultz, Marcus J., Hemmes, Sabrine N. T., Neto, Ary Serpa, Binnekade, Jan M., Canet, Jaume, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, De Abreu, Marcelo Gama, Pelosi, Paolo, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Leva B, Damster S, Plichon B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Juros-Zovko M, Djonoviċ-Omanoviċ D, Serpa Neto A, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Pavičić-Šarić J, Erceg G, Bogdanović Dvorščak M, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Hosny Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy AM, Fathy Hasan W, Gouda Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Putensen C, Krassler J, Merzky S, Gama de Abreu M, Uhlig C, Kiss T, Bundy A, Bluth T, Güldner A, Spieth P, Scharffenberg M, Tran Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, de Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Skirstad Hodt K, Fjellanger F, VicoAvalos M, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco GR, Ferreira D, Amaral J, Gonçalves Castro ML, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Popescu Garotescu I, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan GS, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta C, Puigbo C, Fava J, Canet J, Moret E, Rodriguez Nunez MN, Sendra M, Brunelli A, Rodenas F, Monedero P, Hidalgo Martinez F, Yepes Temino MJ, Marti Nez Simon A, de Abajo Larriba A, Lisi A, Perez G, Martinez R, Granell M, Tatay Vivo J, Saiz Ruiz C, de Andre S Iban Ez JA, Pastor E, Soro M, Ferrando C, Defez M, Aldecoa Alvares-Santullano C, Pere R, Rico J, Jawad M, Saeed Y, Gillberg L, Hedenstierna G, Kazak Bengisun Z, Kansu Kazbek B, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk NM, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ustalar Ozgen S, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin SU, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgün FN, Sanlikarip C, Mine Karaman F, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Mills G, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Vidal Melo M, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Schultz, M, Hemmes, S, Neto, A, Binnekade, J, Canet, J, Hedenstierna, G, Jaber, S, Hiesmayr, M, Hollmann, M, Mills, G, Vidal Melo, M, Pearse, R, Putensen, C, Schmid, W, Severgnini, P, Wrigge, H, De Abreu, M, Pelosi, P, Kroell, W, Metzler, H, Struber, G, Wegscheider, T, Gombotz, H, Urbanek, B, Leva, B, Damster, S, Plichon, B, Kahn, D, Momeni, M, Pospiech, A, Lois, F, Forget, P, Grosu, I, Poelaert, J, van Mossevelde, V, van Malderen, M, Dylst, D, van Melkebeek, J, Beran, M, de Hert, S, De Baerdemaeker, L, Heyse, B, van Limmen, J, Wyffels, P, Jacobs, T, Roels, N, De Bruyne, A, van de Velde, S, Juros-Zovko, M, Djonovic-Omanovic, D, Pernar, S, Zunic, J, Miskovic, P, Zilic, A, Kvolik, S, Ivic, D, Azenic-Venzera, D, Skiljic, S, Vinkovic, H, Oputric, I, Juricic, K, Frkovic, V, Kopic, J, Mirkovic, I, Karanovic, N, Carev, M, Dropulic, N, Pavicic-Saric, J, Erceg, G, Bogdanovic Dvorcak, M, Mazul-Sunko, B, Pavicic, A, Goranovic, T, Maldini, B, Radocaj, T, Gavranovic, Z, Mladic-Batinica, I, Sehovic, M, Stourac, P, Harazim, H, Smekalova, O, Kosinova, M, Kolacek, T, Hudacek, K, Drab, M, Brujevic, J, Vitkova, K, Jirmanova, K, Volfova, I, Dzurnakova, P, Liskova, K, Dudas, R, Filipsky, R, El Kafrawy, S, Hosny Abdelwahab, H, Metwally, T, Abdel-Razek, A, El-Shaarawy, A, Fathy Hasan, W, Gouda Ahmed, A, Yassin, H, Magdy, M, Abdelhady, M, Mahran, M, Herodes, E, Kivik, P, Oganjan, J, Aun, A, Sormus, A, Sarapuu, K, Mall, M, Karjagin, J, Futier, E, Petit, A, Gerard, A, Marret, E, Solier, M, Prades, A, Krassler, J, Merzky, S, Uhlig, C, Kiss, T, Bundy, A, Bluth, T, Guldner, A, Spieth, P, Scharffenberg, M, Tran Thiem, D, Koch, T, Treschan, T, Schaefer, M, Bastin, B, Geib, J, Weiss, M, Kienbaum, P, Pannen, B, Gottschalk, A, Konrad, M, Westerheide, D, Schwerdtfeger, B, Simon, P, Reske, A, Nestler, C, Valsamidis, D, Stroumpoulis, K, Antholopoulos, G, Andreou, A, Karapanos, D, Theodoraki, K, Gkiokas, G, Tasoulis, M, Sidiropoulou, T, Zafeiropoulou, F, Florou, P, Pandazi, A, Tsaousi, G, Nouris, C, Pourzitaki, C, Bystritski, D, Pizov, R, Eden, A, Pesce, C, Campanile, A, Marrella, A, Grasso, S, De Michele, M, Bona, F, Giacoletto, G, Sardo, E, Giancarlo, L, Sottosanti, V, Solca, M, Volta, C, Spadaro, S, Verri, M, Ragazzi, R, Zoppellari, R, Cinnella, G, Raimondo, P, La Bella, D, Mirabella, L, D'Antini, D, Molin, A, Brunetti, I, Gratarola, A, Pellerano, G, Sileo, R, Pezzatto, S, Montagnani, L, Pasin, L, Landoni, G, Zangrillo, A, Beretta, L, Di Parma, A, Tarzia, V, Dossi, R, Sassone, M, Sances, D, Tredici, S, Spano, G, Castellani, G, Delunas, L, Peradze, S, Venturino, M, Arpino, I, Sher, S, Tommasino, C, Rapido, F, Morelli, P, Vargas, M, Servillo, G, Cortegiani, A, Raineri, S, Montalto, F, Russotto, V, Giarratano, A, Baciarello, M, Generali, M, Cerati, G, Leykin, Y, Bressan, F, Bartolini, V, Zamidei, L, Brazzi, L, Liperi, C, Sales, G, Pistidda, L, Brugnoni, E, Musella, G, Bacuzzi, A, Muhardri, D, Gecaj-Gashi, A, Sada, F, Bytyqi, A, Karbonskiene, A, Aukstakalniene, R, Teberaite, Z, Salciute, E, Tikuisis, R, Miliauskas, P, Jurate, S, Kontrimaviciute, E, Tomkute, G, Xuereb, J, Bezzina, M, Borg, F, Wiersma, I, Bos, L, Boer, C, Duvekot, A, In't Veld, B, Werger, A, Dennesen, P, Severijns, C, de Jong, J, Hering, J, van Beek, R, Ivars, S, Jammer, I, Breidablik, A, Skirstad Hodt, K, Fjellanger, F, Vicoavalos, M, Mellin-Olsen, J, Andersson, E, Shafi-Kabiri, A, Molina, R, Wutai, S, Morais, E, Tareco, G, Ferreira, D, Amaral, J, Goncalves Castro, M, Cadilha, S, Appleton, S, Parente, S, Correia, M, Martins, D, Monteirosa, A, Ricardo, A, Rodrigues, S, Horhota, L, Grintescu, I, Mirea, L, Corneci, D, Negoita, S, Dutu, M, Popescu Garotescu, I, Filipescu, D, Prodan, A, Droc, G, Fota, R, Popescu, M, Tomescu, D, Petcu, A, Tudoroiu, M, Moise, A, Guran, C, Gherghina, I, Costea, D, Cindea, I, Copotoiu, S, Copotoiu, R, Barsan, V, Tolcser, Z, Riciu, M, Moldovan, G, Veres, M, Gritsan, A, Kapkan, T, Gritsan, G, Korolkov, O, Kulikov, A, Lubnin, A, Ovezov, A, Prokoshev, P, Lugovoy, A, Anipchenko, N, Babayants, A, Komissarova, I, Zalina, K, Likhvantsev, V, Fedorov, S, Lazukic, A, Pejakovic, J, Mihajlovic, D, Kusnierikova, Z, Zelinkova, M, Bruncakova, K, Polakovicova, L, Sobona, V, Novak-Supe, B, Pekle-Golez, A, Jovanov, M, Strazisar, B, Markovic-Bozic, J, Novak-Jankovic, V, Voje, M, Grynyuk, A, Kostadinov, I, Spindler-Vesel, A, Moral, V, Unzueta, C, Puigbo, C, Fava, J, Moret, E, Rodriguez Nunez, M, Sendra, M, Brunelli, A, Rodenas, F, Monedero, P, Hidalgo Martinez, F, Yepes Temino, M, Marti Nez Simon, A, de Abajo Larriba, A, Lisi, A, Perez, G, Martinez, R, Granell, M, Tatay Vivo, J, Saiz Ruiz, C, de Andre S Iban Ez, J, Pastor, E, Soro, M, Ferrando, C, Defez, M, Aldecoa Alvares-Santullano, C, Pere, R, Rico, J, Jawad, M, Saeed, Y, Gillberg, L, Kazak Bengisun, Z, Kansu Kazbek, B, Coskunfirat, N, Boztug, N, Sanli, S, Yilmaz, M, Hadimioglu, N, Senturk, N, Camci, E, Kucukgoncu, S, Sungur, Z, Sivrikoz, N, Ustalar Ozgen, S, Toraman, F, Selvi, O, Senturk, O, Yildiz, M, Kuvaki, B, Gunenc, F, Kucukguclu, S, Ozbilgin, S, Maral, J, Canli, S, Arun, O, Saltali, A, Aydogan, E, Akgun, F, Sanlikarip, C, Mine Karaman, F, Mazur, A, Vorotyntsev, S, Rousseau, G, Barrett, C, Stancombe, L, Shelley, B, Scholes, H, Limb, J, Rafi, A, Wayman, L, Deane, J, Rogerson, D, Williams, J, Yates, S, Rogers, E, Pulletz, M, Moreton, S, Jones, S, Venkatesh, S, Burton, M, Brown, L, Goodall, C, Rucklidge, M, Fuller, D, Nadolski, M, Kusre, S, Lundberg, M, Everett, L, Nutt, H, Zuleika, M, Carvalho, P, Clements, D, Creagh-Brown, B, Watt, P, Raymode, P, Mohr, O, Raj, A, Creary, T, Chishti, A, Bell, A, Higham, C, Cain, A, Gibb, S, Mowat, S, Franklin, D, West, C, Minto, G, Boyd, N, Calton, E, Walker, R, Mackenzie, F, Ellison, B, Roberts, H, Chikungwa, M, Jackson, C, Donovan, A, Foot, J, Homan, E, Montgomery, J, Portch, D, Mercer, P, Palmer, J, Paddle, J, Fouracres, A, Datson, A, Andrew, A, Welch, L, Rose, A, Varma, S, Simeson, K, Rambhatla, M, Susarla, J, Marri, S, Kodaganallur, K, Das, A, Algarsamy, S, Colley, J, Davies, S, Szewczyk, M, Smith, T, Fernandez-Bustamante, A, Luzier, E, Almagro, A, Fernando, L, Sulemanji, D, Sprung, J, Weingarten, T, Kor, D, Scavonetto, F, Tze, Y, Schultz, M. J., Hemmes, S. N. T., Neto, A. S., Binnekade, J. M., Canet, J., Hedenstierna, G., Jaber, S., Hiesmayr, M., Hollmann, M. W., Mills, G. H., Vidal Melo, M. F., Pearse, R., Putensen, C., Schmid, W., Severgnini, P., Wrigge, H., De Abreu, M. G., Pelosi, P., Kroell, W., Metzler, H., Struber, G., Wegscheider, T., Gombotz, H., Urbanek, B., Leva, B., Damster, S., Plichon, B., Kahn, D., Momeni, M., Pospiech, A., Lois, F., Forget, P., Grosu, I., Poelaert, J., van Mossevelde, V., van Malderen, M. C., Dylst, D., van Melkebeek, J., Beran, M., de Hert, S., De Baerdemaeker, L., Heyse, B., van Limmen, J., Wyffels, P., Jacobs, T., Roels, N., De Bruyne, A., van de Velde, S., Juros-Zovko, M., Djonovic-Omanovic, D., Pernar, S., Zunic, J., Miskovic, P., Zilic, A., Kvolik, S., Ivic, D., Azenic-Venzera, D., Skiljic, S., Vinkovic, H., Oputric, I., Juricic, K., Frkovic, V., Kopic, J., Mirkovic, I., Karanovic, N., Carev, M., Dropulic, N., Pavicic-Saric, J., Erceg, G., Bogdanovic Dvorcak, M., Mazul-Sunko, B., Pavicic, A. M., Goranovic, T., Maldini, B., Radocaj, T., Gavranovic, Z., Mladic-Batinica, I., Sehovic, M., Stourac, P., Harazim, H., Smekalova, O., Kosinova, M., Kolacek, T., Hudacek, K., Drab, M., Brujevic, J., Vitkova, K., Jirmanova, K., Volfova, I., Dzurnakova, P., Liskova, K., Dudas, R., Filipsky, R., El Kafrawy, S., Hosny Abdelwahab, H., Metwally, T., Abdel-Razek, A., El-Shaarawy, A. M., Fathy Hasan, W., Gouda Ahmed, A., Yassin, H., Magdy, M., Abdelhady, M., Mahran, M., Herodes, E., Kivik, P., Oganjan, J., Aun, A., Sormus, A., Sarapuu, K., Mall, M., Karjagin, J., Futier, E., Petit, A., Gerard, A., Marret, E., Solier, M., Prades, A., Krassler, J., Merzky, S., Uhlig, C., Kiss, T., Bundy, A., Bluth, T., Guldner, A., Spieth, P., Scharffenberg, M., Tran Thiem, D., Koch, T., Treschan, T., Schaefer, M., Bastin, B., Geib, J., Weiss, M., Kienbaum, P., Pannen, B., Gottschalk, A., Konrad, M., Westerheide, D., Schwerdtfeger, B., Simon, P., Reske, A., Nestler, C., Valsamidis, D., Stroumpoulis, K., Antholopoulos, G., Andreou, A., Karapanos, D., Theodoraki, K., Gkiokas, G., Tasoulis, M. K., Sidiropoulou, T., Zafeiropoulou, F., Florou, P., Pandazi, A., Tsaousi, G., Nouris, C., Pourzitaki, C., Bystritski, D., Pizov, R., Eden, A., Pesce, C. V., Campanile, A., Marrella, A., Grasso, S., De Michele, M., Bona, F., Giacoletto, G., Sardo, E., Giancarlo, L., Sottosanti, V., Solca, M., Volta, C. A., Spadaro, S., Verri, M., Ragazzi, R., Zoppellari, R., Cinnella, G., Raimondo, P., La Bella, D., Mirabella, L., D'Antini, D., Molin, A., Brunetti, I., Gratarola, A., Pellerano, G., Sileo, R., Pezzatto, S., Montagnani, L., Pasin, L., Landoni, G., Zangrillo, A., Beretta, L., Di Parma, A. L., Tarzia, V., Dossi, R., Sassone, M. E., Sances, D., Tredici, S., Spano, G., Castellani, G., Delunas, L., Peradze, S., Venturino, M., Arpino, I., Sher, S., Tommasino, C., Rapido, F., Morelli, P., Vargas, M., Servillo, G., Cortegiani, A., Raineri, S. M., Montalto, F., Russotto, V., Giarratano, A., Baciarello, M., Generali, M., Cerati, G., Leykin, Y., Bressan, F., Bartolini, V., Zamidei, L., Brazzi, L., Liperi, C., Sales, G., Pistidda, L., Brugnoni, E., Musella, G., Bacuzzi, A., Muhardri, D., Gecaj-Gashi, A., Sada, F., Bytyqi, A., Karbonskiene, A., Aukstakalniene, R., Teberaite, Z., Salciute, E., Tikuisis, R., Miliauskas, P., Jurate, S., Kontrimaviciute, E., Tomkute, G., Xuereb, J., Bezzina, M., Borg, F. J., Wiersma, I., Bos, L., Boer, C., Duvekot, A., In't Veld, B., Werger, A., Dennesen, P., Severijns, C., de Jong, J., Hering, J., van Beek, R., Ivars, S., Jammer, I., Breidablik, A., Skirstad Hodt, K., Fjellanger, F., Vicoavalos, M., Mellin-Olsen, J., Andersson, E., Shafi-Kabiri, A., Molina, R., Wutai, S., Morais, E., Tareco, G. R., Ferreira, D., Amaral, J., Goncalves Castro, M. L., Cadilha, S., Appleton, S., Parente, S., Correia, M., Martins, D., Monteirosa, A., Ricardo, A., Rodrigues, S., Horhota, L., Grintescu, I. M., Mirea, L., Grintescu, I. C., Corneci, D., Negoita, S., Dutu, M., Popescu Garotescu, I., Filipescu, D., Prodan, A. B., Droc, G., Fota, R., Popescu, M., Tomescu, D., Petcu, A. M., Tudoroiu, M. I., Moise, A., Guran, C. T., Gherghina, I., Costea, D., Cindea, I., Copotoiu, S. M., Copotoiu, R., Barsan, V., Tolcser, Z., Riciu, M., Moldovan, G. S., Veres, M., Gritsan, A., Kapkan, T., Gritsan, G., Korolkov, O., Kulikov, A., Lubnin, A., Ovezov, A., Prokoshev, P., Lugovoy, A., Anipchenko, N., Babayants, A., Komissarova, I., Zalina, K., Likhvantsev, V., Fedorov, S., Lazukic, A., Pejakovic, J., Mihajlovic, D., Kusnierikova, Z., Zelinkova, M., Bruncakova, K., Polakovicova, L., Sobona, V., Novak-Supe, B., Pekle-Golez, A., Jovanov, M., Strazisar, B., Markovic-Bozic, J., Novak-Jankovic, V., Voje, M., Grynyuk, A., Kostadinov, I., Spindler-Vesel, A., Moral, V., Unzueta, C., Puigbo, C., Fava, J., Moret, E., Rodriguez Nunez, M. N., Sendra, M., Brunelli, A., Rodenas, F., Monedero, P., Hidalgo Martinez, F., Yepes Temino, M. J., Marti Nez Simon, A., de Abajo Larriba, A., Lisi, A., Perez, G., Martinez, R., Granell, M., Tatay Vivo, J., Saiz Ruiz, C., de Andre S Iban Ez, J. A., Pastor, E., Soro, M., Ferrando, C., Defez, M., Aldecoa Alvares-Santullano, C., Pere, R., Rico, J., Jawad, M., Saeed, Y., Gillberg, L., Kazak Bengisun, Z., Kansu Kazbek, B., Coskunfirat, N., Boztug, N., Sanli, S., Yilmaz, M., Hadimioglu, N., Senturk, N. M., Camci, E., Kucukgoncu, S., Sungur, Z., Sivrikoz, N., Ustalar Ozgen, S., Toraman, F., Selvi, O., Senturk, O., Yildiz, M., Kuvaki, B., Gunenc, F., Kucukguclu, S., Ozbilgin, S. U., Maral, J., Canli, S., Arun, O., Saltali, A., Aydogan, E., Akgun, F. N., Sanlikarip, C., Mine Karaman, F., Mazur, A., Vorotyntsev, S., Rousseau, G., Barrett, C., Stancombe, L., Shelley, B., Scholes, H., Limb, J., Rafi, A., Wayman, L., Deane, J., Rogerson, D., Williams, J., Yates, S., Rogers, E., Pulletz, M., Moreton, S., Jones, S., Venkatesh, S., Burton, M., Brown, L., Goodall, C., Rucklidge, M., Fuller, D., Nadolski, M., Kusre, S., Lundberg, M., Everett, L., Nutt, H., Zuleika, M., Carvalho, P., Clements, D., Creagh-Brown, B., Watt, P., Raymode, P., Mohr, O., Raj, A., Creary, T., Chishti, A., Bell, A., Higham, C., Cain, A., Gibb, S., Mowat, S., Franklin, D., West, C., Minto, G., Boyd, N., Calton, E., Walker, R., Mackenzie, F., Ellison, B., Roberts, H., Chikungwa, M., Jackson, C., Donovan, A., Foot, J., Homan, E., Montgomery, J., Portch, D., Mercer, P., Palmer, J., Paddle, J., Fouracres, A., Datson, A., Andrew, A., Welch, L., Rose, A., Varma, S., Simeson, K., Rambhatla, M., Susarla, J., Marri, S., Kodaganallur, K., Das, A., Algarsamy, S., Colley, J., Davies, S., Szewczyk, M., Smith, T., Fernandez-Bustamante, A., Luzier, E., Almagro, A., Fernando, L., Sulemanji, D., Sprung, J., Weingarten, T., Kor, D., Scavonetto, F., Tze, Y., Anesthesiology, ACS - Microcirculation, ACS - Diabetes & metabolism, Landoni, Giovanni, Zangrillo, Alberto, Beretta, Luigi, Schultz, Marcus J., Hemmes, Sabrine N.T., Neto, Ary Serpa, Binnekade, Jan M., Canet, Jaume, Hedenstierna, Goran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Vidal Melo, Marcos F., Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, De Abreu, Marcelo Gama, Pelosi, Paolo, Kroell W, Metzler H, Struber G, Wegscheider T, Gombotz H, Hiesmayr M, Schmid W, Urbanek B, Leva B, Damster S, Plichon B, Kahn D, Momeni M, Pospiech A, Lois F, Forget P, Grosu I, Poelaert J, van Mossevelde V, van Malderen MC, Dylst D, van Melkebeek J, Beran M, de Hert S, De Baerdemaeker L, Heyse B, van Limmen J, Wyffels P, Jacobs T, Roels N, De Bruyne A, van de Velde S, Juros-Zovko M, Djonoviċ-Omanoviċ D, Serpa Neto A, Pernar S, Zunic J, Miskovic P, Zilic A, Kvolik S, Ivic D, Azenic-Venzera D, Skiljic S, Vinkovic H, Oputric I, Juricic K, Frkovic V, Kopic J, Mirkovic I, Karanovic N, Carev M, Dropulic N, Pavičić-Šarić J, Erceg G, Bogdanović Dvorščak M, Mazul-Sunko B, Pavicic AM, Goranovic T, Maldini B, Radocaj T, Gavranovic Z, Mladic-Batinica I, Sehovic M, Stourac P, Harazim H, Smekalova O, Kosinova M, Kolacek T, Hudacek K, Drab M, Brujevic J, Vitkova K, Jirmanova K, Volfova I, Dzurnakova P, Liskova K, Dudas R, Filipsky R, El Kafrawy S, Hosny Abdelwahab H, Metwally T, Abdel-Razek A, El-Shaarawy AM, Fathy Hasan W, Gouda Ahmed A, Yassin H, Magdy M, Abdelhady M, Mahran M, Herodes E, Kivik P, Oganjan J, Aun A, Sormus A, Sarapuu K, Mall M, Karjagin J, Futier E, Petit A, Gerard A, Marret E, Solier M, Jaber S, Prades A, Putensen C, Krassler J, Merzky S, Gama de Abreu M, Uhlig C, Kiss T, Bundy A, Bluth T, Güldner A, Spieth P, Scharffenberg M, Tran Thiem D, Koch T, Treschan T, Schaefer M, Bastin B, Geib J, Weiss M, Kienbaum P, Pannen B, Gottschalk A, Konrad M, Westerheide D, Schwerdtfeger B, Wrigge H, Simon P, Reske A, Nestler C, Valsamidis D, Stroumpoulis K, Antholopoulos G, Andreou A, Karapanos D, Theodoraki K, Gkiokas G, Tasoulis MK, Sidiropoulou T, Zafeiropoulou F, Florou P, Pandazi A, Tsaousi G, Nouris C, Pourzitaki C, Bystritski D, Pizov R, Eden A, Pesce CV, Campanile A, Marrella A, Grasso S, De Michele M, Bona F, Giacoletto G, Sardo E, Giancarlo L, Sottosanti V, Solca M, Volta CA, Spadaro S, Verri M, Ragazzi R, Zoppellari R, Cinnella G, Raimondo P, La Bella D, Mirabella L, D'antini D, Pelosi P, Molin A, Brunetti I, Gratarola A, Pellerano G, Sileo R, Pezzatto S, Montagnani L, Pasin L, Landoni G, Zangrillo A, Beretta L, Di Parma AL, Tarzia V, Dossi R, Sassone ME, Sances D, Tredici S, Spano G, Castellani G, Delunas L, Peradze S, Venturino M, Arpino I, Sher S, Tommasino C, Rapido F, Morelli P, Vargas M, Servillo G, Cortegiani A, Raineri SM, Montalto F, Russotto V, Giarratano A, Baciarello M, Generali M, Cerati G, Leykin Y, Bressan F, Bartolini V, Zamidei L, Brazzi L, Liperi C, Sales G, Pistidda L, Severgnini P, Brugnoni E, Musella G, Bacuzzi A, Muhardri D, Gecaj-Gashi A, Sada F, Bytyqi A, Karbonskiene A, Aukstakalniene R, Teberaite Z, Salciute E, Tikuisis R, Miliauskas P, Jurate S, Kontrimaviciute E, Tomkute G, Xuereb J, Bezzina M, Borg FJ, Hemmes S, Schultz M, Hollmann M, Wiersma I, Binnekade J, Bos L, Boer C, Duvekot A, In 't Veld B, Werger A, Dennesen P, Severijns C, de Jong J, Hering J, van Beek R, Ivars S, Jammer I, Breidablik A, Skirstad Hodt K, Fjellanger F, VicoAvalos M, Mellin-Olsen J, Andersson E, Shafi-Kabiri A, Molina R, Wutai S, Morais E, Tareco GR, Ferreira D, Amaral J, Gonçalves Castro ML, Cadilha S, Appleton S, Parente S, Correia M, Martins D, Monteirosa A, Ricardo A, Rodrigues S, Horhota L, Grintescu IM, Mirea L, Grintescu IC, Corneci D, Negoita S, Dutu M, Popescu Garotescu I, Filipescu D, Prodan AB, Droc G, Fota R, Popescu M, Tomescu D, Petcu AM, Tudoroiu MI, Moise A, Guran CT, Gherghina I, Costea D, Cindea I, Copotoiu SM, Copotoiu R, Barsan V, Tolcser Z, Riciu M, Moldovan GS, Veres M, Gritsan A, Kapkan T, Gritsan G, Korolkov O, Kulikov A, Lubnin A, Ovezov A, Prokoshev P, Lugovoy A, Anipchenko N, Babayants A, Komissarova I, Zalina K, Likhvantsev V, Fedorov S, Lazukic A, Pejakovic J, Mihajlovic D, Kusnierikova Z, Zelinkova M, Bruncakova K, Polakovicova L, Sobona V, Novak-Supe B, Pekle-Golez A, Jovanov M, Strazisar B, Markovic-Bozic J, Novak-Jankovic V, Voje M, Grynyuk A, Kostadinov I, Spindler-Vesel A, Moral V, Unzueta C, Puigbo C, Fava J, Canet J, Moret E, Rodriguez Nunez MN, Sendra M, Brunelli A, Rodenas F, Monedero P, Hidalgo Martinez F, Yepes Temino MJ, Marti Nez Simon A, de Abajo Larriba A, Lisi A, Perez G, Martinez R, Granell M, Tatay Vivo J, Saiz Ruiz C, de Andre S Iban Ez JA, Pastor E, Soro M, Ferrando C, Defez M, Aldecoa Alvares-Santullano C, Pere R, Rico J, Jawad M, Saeed Y, Gillberg L, Hedenstierna G, Kazak Bengisun Z, Kansu Kazbek B, Coskunfirat N, Boztug N, Sanli S, Yilmaz M, Hadimioglu N, Senturk NM, Camci E, Kucukgoncu S, Sungur Z, Sivrikoz N, Ustalar Ozgen S, Toraman F, Selvi O, Senturk O, Yildiz M, Kuvaki B, Gunenc F, Kucukguclu S, Ozbilgin SU, Maral J, Canli S, Arun O, Saltali A, Aydogan E, Akgün FN, Sanlikarip C, Mine Karaman F, Mazur A, Vorotyntsev S, Rousseau G, Barrett C, Stancombe L, Shelley B, Scholes H, Limb J, Rafi A, Wayman L, Deane J, Rogerson D, Williams J, Yates S, Rogers E, Pulletz M, Moreton S, Jones S, Venkatesh S, Burton M, Brown L, Goodall C, Rucklidge M, Fuller D, Nadolski M, Kusre S, Lundberg M, Everett L, Nutt H, Zuleika M, Carvalho P, Clements D, Creagh-Brown B, Watt P, Raymode P, Pearse R, Mohr O, Raj A, Creary T, Chishti A, Bell A, Higham C, Cain A, Gibb S, Mowat S, Franklin D, West C, Minto G, Boyd N, Mills G, Calton E, Walker R, Mackenzie F, Ellison B, Roberts H, Chikungwa M, Jackson C, Donovan A, Foot J, Homan E, Montgomery J, Portch D, Mercer P, Palmer J, Paddle J, Fouracres A, Datson A, Andrew A, Welch L, Rose A, Varma S, Simeson K, Rambhatla M, Susarla J, Marri S, Kodaganallur K, Das A, Algarsamy S, Colley J, Davies S, Szewczyk M, Smith T, Fernandez-Bustamante A, Luzier E, Almagro A, Vidal Melo M, Fernando L, Sulemanji D, Sprung J, Weingarten T, Kor D, Scavonetto F, Tze Y., Graduate School, ACS - Pulmonary hypertension & thrombosis, Intensive Care Medicine, AII - Amsterdam institute for Infection and Immunity, AII - Inflammatory diseases, ACS - Amsterdam Cardiovascular Sciences, ACS - Heart failure & arrhythmias, Anesthesiology research group, and Supporting clinical sciences

Subjects
Male, Pediatrics, Internationality, RESPIRATORY-DISTRESS-SYNDROME, 0302 clinical medicine, Postoperative Complications, 030202 anesthesiology, Risk Factors, Epidemiology, ABDOMINAL-SURGERY, 80 and over, Medicine and Health Sciences, General anaesthesia, Anesthesia, END-EXPIRATORY-PRESSURE, BERLIN DEFINITION, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Lung, Aged, 80 and over, Framingham Risk Score, Incidence (epidemiology), Respiration, Middle Aged, Treatment Outcome, Artificial, Female, PRACTICE PATTERNS, Human, medicine.medical_specialty, mechanical ventilation, prospective observational study, Intensive care, Anesthesia, General, NONCARDIOTHORACIC SURGERY, NO, Aged, Cross-Sectional Studies, Humans, Intraoperative Care, Respiration Disorders, Respiration, Artificial, Tidal Volume, Anesthesiology and Pain Medicine, ACUTE LUNG INJURY, 03 medical and health sciences, GENERAL-ANESTHESIA, Internal medicine, medicine, Journal Article, MED/41 - ANESTESIOLOGIA, General, Cross-Sectional Studie, business.industry, Risk Factor, Respiration Disorder, Confidence interval, PROTECTIVE MECHANICAL VENTILATION, Prospective Studie, Relative risk, MAJOR NONCARDIAC SURGERY, Postoperative Complication, business, Abdominal surgery
Abstract

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.

Published
2017
Full Text
View/download PDF

27. Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study.

Author

Robba, Chiara, Hemmes, Sabrine N. T., Serpa Neto, Ary, Bluth, Thomas, Canet, Jaume, Hiesmayr, Michael, Hollmann, M. Wiersma, Mills, Gary H., Vidal Melo, Marcos F., Putensen, Christian, Jaber, Samir, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, Battaglini, Denise, Ball, Lorenzo, Gama de Abreu, Marcelo, Schultz, Marcus J., Pelosi, Paolo, and FERS for the LAS VEGAS investigators

Subjects
*SPINAL surgery, *AGE distribution, *ARTIFICIAL respiration, *BODY weight, *BRAIN surgery, *CONFIDENCE intervals, *LUNG diseases, *INTRAOPERATIVE care, *PATIENTS, *RESPIRATORY measurements, *PULMONARY function tests, *RISK assessment, *STATISTICS, *SURGERY, *TIME, *DATA analysis, *GENERAL anesthesia, *ODDS ratio, *DISEASE risk factors, SURGICAL complication risk factors
Abstract

Background: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. Methods: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. Results: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3–9] per predicted body weight; median positive end–expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. Conclusions: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

28. Driving Pressure During General Anesthesia for Open Abdominal Surgery (DESIGNATION): study protocol of a randomized clinical trial.

Author

The DESIGNATION–investigators, Hol, Liselotte, Nijbroek, Sunny G. L. H., Neto, Ary Serpa, de Abreu, Marcelo Gama, Pelosi, Paolo, Hemmes, Sabrine N. T., Aarts, Leon P. H. J., Akkerman, Ronald D. L., Albersen, Juliette J. E., Aurilio, Caterina, Battaglini, Denise, de Boer, Hans D., Boom, Annemieke, Boer, Christa, Brouwer, Tammo, Buhre, Wolfgang F. F. A., Bulte, Carolina S. E., Edward-Rutten, Gitara M., and Godfried, Marc B.

Subjects
ABDOMINAL surgery, CLINICAL trials, POSITIVE end-expiratory pressure, GENERAL anesthesia, BODY mass index, UBIQUINONES
Abstract

Background: Intraoperative driving pressure (ΔP) is associated with development of postoperative pulmonary complications (PPC). When tidal volume (VT) is kept constant, ΔP may change according to positive end-expiratory pressure (PEEP)-induced changes in lung aeration. ΔP may decrease if PEEP leads to a recruitment of collapsed lung tissue but will increase if PEEP mainly causes pulmonary overdistension. This study tests the hypothesis that individualized high PEEP, when compared to fixed low PEEP, protects against PPC in patients undergoing open abdominal surgery.Methods: The "Driving prESsure durIng GeNeral AnesThesIa for Open abdomiNal surgery trial" (DESIGNATION) is an international, multicenter, two-group, double-blind randomized clinical superiority trial. A total of 1468 patients will be randomly assigned to one of the two intraoperative ventilation strategies. Investigators screen patients aged ≥ 18 years and with a body mass index ≤ 40 kg/m2, scheduled for open abdominal surgery and at risk for PPC. Patients either receive an intraoperative ventilation strategy with individualized high PEEP with recruitment maneuvers (RM) ("individualized high PEEP") or one in which PEEP of 5 cm H2O without RM is used ("low PEEP"). In the "individualized high PEEP" group, PEEP is set at the level at which ΔP is lowest. In both groups of the trial, VT is kept at 8 mL/kg predicted body weight. The primary endpoint is the occurrence of PPC, recorded as a collapsed composite of adverse pulmonary events.Discussion: DESIGNATION will be the first randomized clinical trial that is adequately powered to compare the effects of individualized high PEEP with RM versus fixed low PEEP without RM on the occurrence of PPC after open abdominal surgery. The results of DESIGNATION will support anesthesiologists in their decisions regarding PEEP settings during open abdominal surgery.Trial Registration: Clinicaltrials.gov, NCT03884543. Registered on 21 March 2019. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

29. Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications : LAS VEGAS - an observational study in 29 countries

Author

Hemmes, Sabrine N. T., Neto, Ary Serpa, Binnekade, Jan M., Canet, Jaume, Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Melo, Marcos F. Vidal, Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J., Hemmes, Sabrine N. T., Neto, Ary Serpa, Binnekade, Jan M., Canet, Jaume, Hedenstierna, Göran, Jaber, Samir, Hiesmayr, Michael, Hollmann, Markus W., Mills, Gary H., Melo, Marcos F. Vidal, Pearse, Rupert, Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at incre, Group Author(s): LAS VEGAS Investigators

Published
2017
Full Text
View/download PDF

30. One Size Does Not Fit All Reply

Author

Güldner, Andreas, Kiss, Thomas, Serpa Neto, Ary, Hemmes, Sabrine N. T., Canet, Jaume, Spieth, Peter M., Rocco, Patricia R. M., Schultz, Marcus J., Pelosi, Paolo, Gama de Abreu, Marcelo, Intensive Care Medicine, Amsterdam institute for Infection and Immunity, and Anesthesiology

Published
2016

31. Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis

Author

Serpa Neto, Ary, Hemmes, Sabrine N. T., Barbas, Carmen S. V., Beiderlinden, Martin, Biehl, Michelle, Binnekade, Jan M., Canet, Jaume, Fernandez-Bustamante, Ana, Futier, Emmanuel, Gajic, Ognjen, Hedenstierna, Göran, Hollmann, Markus W., Jaber, Samir, Kozian, Alf, Licker, Marc, Lin, Wen-Qian, Maslow, Andrew D., Memtsoudis, Stavros G., Reis Miranda, Dinis, Moine, Pierre, Thomas, Ng, Paparella, Domenico, Putensen, Christian, Ranieri, Marco, Scavonetto, Federica, Schilling, Thomas, Schmid, Werner, Selmo, Gabriele, Severgnini, Paolo, Sprung, Juraj, Sundar, Sugantha, Talmor, Daniel, Treschan, Tanja, Unzueta, Carmen, Weingarten, Toby N., Wolthuis, Esther K., Wrigge, Hermann, Gama De Abreu, Marcelo, Pelosi, Paolo, Schultz, Marcus J., University of Amsterdam [Amsterdam] (UvA), Mayo Clinic [Rochester], CHU Clermont-Ferrand, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Otto-von-Guericke University [Magdeburg] (OVGU), University of Bari Aldo Moro (UNIBA), University of Insubria, Varese, Intensive Care, Serpa Neto, A., Hemmes, S.N.T., Barbas, C.S.V., Beiderlinden, M., Biehl, M., Binnekade, J.M., Canet, J., Fernandez-Bustamante, A., Futier, E., Gajic, O., Hedenstierna, G., Hollmann, M.W., Jaber, S., Kozian, A., Licker, M., Lin, W.-Q., Maslow, A.D., Memtsoudis, S.G., Reis Miranda, D., Moine, P., Ng, T., Paparella, D., Putensen, C., Ranieri, M., Scavonetto, F., Schilling, T., Schmid, W., Selmo, G., Severgnini, P., Sprung, J., Sundar, S., Talmor, D., Treschan, T., Unzueta, C., Weingarten, T.N., Wolthuis, E.K., Wrigge, H., Gama De Abreu, M., Pelosi, P., Schultz, M.J., Intensive Care Medicine, AII - Amsterdam institute for Infection and Immunity, Anesthesiology, Other Research, and ACS - Amsterdam Cardiovascular Sciences

Subjects
general surgery, ventilator, procedure, statistic, [SDV]Life Sciences [q-bio], Statistics as Topic, Article, tidal volume, Human, Positive-Pressure Respiration, systematic review, dose response, patient coding, lung complication, Tidal Volume, Humans, postoperative complication, human, randomized controlled trial (topic), comparative study, ComputingMilieux_MISCELLANEOUS, Randomized Controlled Trials as Topic, meta analysi, Respiration, standard, artificial ventilation, Respiration, Artificial, Anesthesiology and Pain Medicine, priority journal, risk factor, positive end expiratory pressure, Artificial, physiology
Abstract

Background: Recent studies show that intraoperative mechanical ventilation using low tidal volumes (V-T) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between V-T size and positive end-expiratory pressure (PEEP) level and occurrence of PPC. Methods: Randomized controlled trials comparing protective ventilation (low V-T with or without high levels of PEEP) and conventional ventilation (high V-T with low PEEP) in patients undergoing general surgery. The primary outcome was development of PPC. Predefined prognostic factors were tested using multivariate logistic regression. Results: Fifteen randomized controlled trials were included (2,127 patients). There were 97 cases of PPC in 1,118 patients (8.7%) assigned to protective ventilation and 148 cases in 1,009 patients (14.7%) assigned to conventional ventilation (adjusted relative risk, 0.64; 95% CI, 0.46 to 0.88; P < 0.01). There were 85 cases of PPC in 957 patients (8.9%) assigned to ventilation with low V-T and high PEEP levels and 63 cases in 525 patients (12%) assigned to ventilation with low V-T and low PEEP levels (adjusted relative risk, 0.93; 95% CI, 0.64 to 1.37; P = 0.72). A dose-response relationship was found between the appearance of PPC and V-T size (R-2 = 0.39) but not between the appearance of PPC and PEEP level (R-2 = 0.08). Conclusions: These data support the beneficial effects of ventilation with use of low V-T in patients undergoing surgery. Further trials are necessary to define the role of intraoperative higher PEEP to prevent PPC during nonopen abdominal surgery.

Published
2015
Full Text
View/download PDF

34. Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT) : an international, multicentre, prospective study

Author

Serpa Neto, Ary, Barbas, Carmen S. V., Simonis, Fabienne D., Artigas-Raventos, Antonio, Canet, Jaume, Determann, Rogier M., Anstey, James, Hedenstierna, Göran, Hemmes, Sabrine N. T., Hermans, Greet, Hiesmayr, Michael, Hollmann, Markus W., Jaber, Samir, Martin-Loeches, Ignacio, Mills, Gary H., Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Smith, Roger, Treschan, Tanja A., Tschernko, Edda M., Melo, Marcos F. V., Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J., Serpa Neto, Ary, Barbas, Carmen S. V., Simonis, Fabienne D., Artigas-Raventos, Antonio, Canet, Jaume, Determann, Rogier M., Anstey, James, Hedenstierna, Göran, Hemmes, Sabrine N. T., Hermans, Greet, Hiesmayr, Michael, Hollmann, Markus W., Jaber, Samir, Martin-Loeches, Ignacio, Mills, Gary H., Pearse, Rupert M., Putensen, Christian, Schmid, Werner, Severgnini, Paolo, Smith, Roger, Treschan, Tanja A., Tschernko, Edda M., Melo, Marcos F. V., Wrigge, Hermann, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were receiving mechanical ventilation in participating ICUs during a 1-week period between January, 2014, and January, 2015, were enrolled into the study. The Lung Injury Prediction Score (LIPS) was used to stratify risk of ARDS, with a score of 4 or higher defining those at risk of ARDS. The primary outcome was the proportion of patients at risk of ARDS. Secondary outcomes included ventilatory management (including tidal volume [V-T] expressed as mL/kg predicted bodyweight [PBW], and positive end-expiratory pressure [PEEP] expressed as cm H2O), development of pulmonary complications, and clinical outcomes. The PRoVENT study is registered at ClinicalTrials.gov, NCT01868321. The study has been completed. Findings Of 3023 patients screened for the study, 935 individuals fulfilled the inclusion criteria. Of these critically ill patients, 282 were at risk of ARDS (30%, 95% CI 27-33), representing 0.14 cases per ICU bed over a 1-week period. V-T was similar for patients at risk and not at risk of ARDS (median 7.6 mL/kg PBW [IQR 6.7-9.1] vs 7.9 mL/kg PBW [6.8-9.1]; p=0.346). PEEP was higher in patients at risk of ARDS compared with those not at risk (median 6.0 cm H2O [IQR 5.0-8.0] vs 5.0 cm H2O [5.0-7.0]; p<0.0001). The prevalence of ARDS in patients at risk of ARDS was higher than in indivi

Published
2016
Full Text
View/download PDF

35. Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensive care units from 16 countries (PRoVENT): an international, multicentre, prospective study

Author

Neto, Ary Serpa, primary, Barbas, Carmen S V, additional, Simonis, Fabienne D, additional, Artigas-Raventós, Antonio, additional, Canet, Jaume, additional, Determann, Rogier M, additional, Anstey, James, additional, Hedenstierna, Goran, additional, Hemmes, Sabrine N T, additional, Hermans, Greet, additional, Hiesmayr, Michael, additional, Hollmann, Markus W, additional, Jaber, Samir, additional, Martin-Loeches, Ignacio, additional, Mills, Gary H, additional, Pearse, Rupert M, additional, Putensen, Christian, additional, Schmid, Werner, additional, Severgnini, Paolo, additional, Smith, Roger, additional, Treschan, Tanja A, additional, Tschernko, Edda M, additional, Melo, Marcos F V, additional, Wrigge, Hermann, additional, de Abreu, Marcelo Gama, additional, Pelosi, Paolo, additional, Schultz, Marcus J, additional, Bell, Adam, additional, Gecaj-Gashi, Agreta, additional, Dilek, Ahmet, additional, Denker, Ahmet Sukru, additional, Aytulun, Akut, additional, Kienbaum, Peter, additional, Rose, Alastair, additional, Bacuzzi, Alessandro, additional, Cavalcanti, Alexandre Biasi, additional, Chan, Alexandre, additional, Molin, Alexandre, additional, Ghosh, Alison, additional, Roy, Alistair, additional, Cowton, Amanda, additional, Skinner, Amanda, additional, Whileman, Amanda, additional, McInerney, Amy, additional, Peçanha, Ana Carolina, additional, Cortegiani, Andrea, additional, Sribar, Andrej, additional, Bentley, Andrew, additional, Corner, Andrew, additional, Pinder, Angela, additional, Hormis, Anil, additional, Walker, Anna, additional, Neto, Ary Serpa, additional, Dixon, Barry, additional, Creagh-Brown, Ben, additional, Volta, Carlo Alberto, additional, Munhoz, Carlos, additional, Brown, Carly, additional, Scott, Carmen, additional, Wreybrown, Caroline, additional, Plowright, Catherine, additional, Downes, Charlotte, additional, Padilla-Harris, Cheryl, additional, Hughes, Chloe, additional, Frey, Christian, additional, Schlegel, Christian, additional, Boyd, Christine, additional, Ryan, Christine, additional, Muench, Christoph, additional, Smalley, Christopher, additional, Zincircioglu, Çiler, additional, Harris, Clair, additional, Kaloo, Claire, additional, Matthews, Claire, additional, Miller, Claire, additional, Pegg, Claire, additional, Bullock, Clare, additional, Mellis, Clare, additional, Piras, Claudio, additional, Seasman, Colette, additional, Santos, Cristina, additional, Beraldo, Daniel, additional, Collins, Daniel, additional, Hadfield, Daniel, additional, Hull, Daniel, additional, Prado, Daniel, additional, Pogson, David, additional, Rogerson, David, additional, Shaw, David, additional, D'Antini, Davide, additional, Griffin, Dawn Trodd Denise, additional, Weller, Debbie, additional, Smith, Deborah, additional, Wilson, Deborah, additional, Aydin, Demet, additional, Donaldson, Denise, additional, Mestria, Donatella, additional, Lauro, Eduardo Di, additional, Caser, Eliane Bernadete, additional, Seghelini, Elisa, additional, Cirstea, Emanuel, additional, Young, Eoin, additional, Alberts, Erna, additional, Senturk, Evren, additional, Brohi, Farooq, additional, Ulger, Fatma, additional, Kahveci, Feda, additional, da Silva Ramos, Fernando José, additional, Van Haren, Frank, additional, Turan, Güldem, additional, Sales, Gabriele, additional, Clifford, Gayle, additional, Cinnella, Gilda, additional, Mecatti, Giovana Colozza, additional, Melchionda, Giuseppe, additional, Eren, Gulay, additional, Crowther, Hannah, additional, Spencer, Hazel, additional, Blaylock, Heather, additional, Green, Helen, additional, Robertson, Helen, additional, Rodgers, Helen, additional, Talbot, Helen, additional, Wong, Helen, additional, Barcraft-Barnes, Helena, additional, Ceunen, Helga, additional, Reschreiter, Henrik, additional, Ulusoy, Hulya, additional, Toman, Huseyin, additional, McCullagh, Iain, additional, White, Ian, additional, Welters, Ingeborg, additional, van den Hul, Ingrid, additional, Gava, Isabela Ambrósio, additional, Reed, Isabelle, additional, Kose, Isil, additional, Maia, Israel, additional, Limb, James, additional, Máca, Jan, additional, Adderly, Jane, additional, Hunt, Jane, additional, Martin, Jane, additional, Montgomery, Jane, additional, Snell, Jane, additional, Salgado, Jean, additional, Ritzema, Jenny, additional, Bewley, Jeremy, additional, Howe, Joanne, additional, Decruyenaere, Johan, additional, Mouland, Johanna, additional, Stickley, Johanna, additional, Mellinghoff, Johannes, additional, Criswell, John, additional, Knighton, John, additional, Cooper, Jonathan, additional, Harrison, Jonathan, additional, Paddle, Jonathan, additional, Pellegrini, Jose Augusto Santos, additional, Needleman, Joseph, additional, Giles, Julian, additional, Camsooksai, Julie, additional, Furneval, Julie, additional, Toms, Julie, additional, Burt, Karen, additional, Simeson, Karen, additional, Williams, Karen, additional, Blenk, Karl, additional, Turner, Kate, additional, Lynch, Katie, additional, Sweet, Katie, additional, Hugill, Keith, additional, Matthews, Kelly, additional, Ruas, Kessia, additional, Clarkson, Kevin, additional, Preller, Kobus, additional, Joyce, Kristen, additional, Ortiz-Ruiz, Laura, additional, Youds, Laura, additional, Tbaily, Lee, additional, Barrell, Lisa, additional, Grimmer, Lisa, additional, Soyoral, Lokman, additional, Peluso, Lorenzo, additional, Murray, Lorna, additional, Niska, Lotta, additional, Tonks, Louise, additional, Fasting, Lousie, additional, DeCrop, Luc, additional, Brazzi, Luca, additional, Mirabella, Lucia, additional, Cooper, Lucy, additional, Falcão, Luis Fernando, additional, Everett, Lynn, additional, Watters, Malcolm, additional, Carnahan, Mandy, additional, Bourgeois, Marc, additional, Abreu, Marcelo Gama de, additional, Romano, Marcelo Luz Pereira, additional, Botteri, Marco, additional, Melo, Marcos F Vidal, additional, Faulkner, Maria, additional, Krkusek, Marijana, additional, Bahl, Marina, additional, Holliday, Mark, additional, Kol, Mark, additional, Pulletz, Mark, additional, Kozlowski, Marta, additional, Dvorscak, Matea Bogdanovic, additional, Jurjevic, Matija, additional, Koopmans, Matty, additional, Morales, Mauricio, additional, Schaefer, Maximilian, additional, Brazier, Melinda, additional, Harris, Meredith, additional, Devile, Michael, additional, Kuiper, Michael, additional, Parris, Michael, additional, Sharman, Michael, additional, Kratochvil, Milan, additional, Ramali, Mohamed, additional, dos Santos, Moreno Calcagnotto, additional, Bynorth, Natalie, additional, Wilson, Natalie, additional, Anquez, Nathalie, additional, Huneke, Nathan, additional, Dogan, Nazim, additional, Karanovic, Nenad, additional, Tarmey, Nicholas, additional, Carreño, Nicolás, additional, Fisher, Nicola, additional, Lamb, Nicola, additional, Venner, Nicola, additional, Hollister, Nigel, additional, Akgun, Nur, additional, Ekinci, Osman, additional, Boyd, Owen, additional, Gill, Pardeep, additional, Raimondo, Pasquale, additional, Verrastro, Pasquale, additional, Pulak, Paul, additional, Fitzell, Pauline, additional, Dark, Paulo, additional, Alzugaray, Pedro, additional, Özcan, Perihan Ergin, additional, MacNaughton, Peter, additional, Stourac, Petr, additional, Hopkins, Phil, additional, Tuinman, Pieter Roel, additional, Pearson, Rachel, additional, Walker, Rachel, additional, Santos, Rafaella Souza dos, additional, Caione, Raffaele, additional, Matsa, Ramprasad, additional, Oliver, Rebecca, additional, Jacob, Reni, additional, Howard-Griffin, Richard, additional, Wilde, Robert BP de, additional, Plant, Robert, additional, Hollands, Robin, additional, Biondi, Rodrigo, additional, Jaafar, Rola, additional, Avendaño, Rossana, additional, Salt, Ruth, additional, Humphries, Ryan, additional, Pinto, Sérgio Felix, additional, Pearson, Sallyane, additional, Hendry, Sam, additional, Lakhani, Sandeep, additional, Beavis, Sarah, additional, Moreton, Sarah, additional, Prudden, Sarah, additional, Thornthwaite, Sarah, additional, Spadaro, Savino, additional, Saylan, Sedat, additional, Chenna, Shailaja, additional, Gopal, Shammer, additional, James, Shanaz, additional, Suresh, Sheeba, additional, Birch, Sian, additional, Skilijic, Sonja, additional, Aguirre, Stefania, additional, Metherell, Stella, additional, Bell, Stephanie, additional, Janes, Stephanie, additional, Wright, Stephen, additional, Rose, Steve, additional, Windebank, Steve, additional, Glenn, Sue, additional, Melbourne, Susan, additional, Tyson, Susan, additional, Leaver, Susannah, additional, Patel, Tasmin, additional, Simurina, Tatjana, additional, Sewell, Terri-Ann, additional, Macruz, Tiago, additional, Hatton, Tom, additional, Evans, Tracey, additional, Goktas, Ugur, additional, Poultney, Una, additional, Buyukkocak, Unase, additional, Linnett, Vanessa, additional, Oliveira, Vanessa, additional, Russotto, Vincenzo, additional, Klaric, Vlasta, additional, Orak, Yavuz, additional, and Demirtürk, Zerrin, additional

Published
2016
Full Text
View/download PDF

36. In Reply

Author

Güldner, Andreas, primary, Kiss, Thomas, additional, Serpa Neto, Ary, additional, Hemmes, Sabrine N. T., additional, Canet, Jaume, additional, Spieth, Peter M., additional, Rocco, Patricia R. M., additional, Schultz, Marcus J., additional, Pelosi, Paolo, additional, and Gama de Abreu, Marcelo, additional

Published
2016
Full Text
View/download PDF

37. In Reply

Author

Güldner, Andreas, primary, Kiss, Thomas, additional, Serpa Neto, Ary, additional, Hemmes, Sabrine N. T., additional, Canet, Jaume, additional, Spieth, Peter M., additional, Rocco, Patricia R. M., additional, Schultz, Marcus J., additional, Pelosi, Paolo, additional, and Gama de Abreu, Marcelo, additional

Published
2015
Full Text
View/download PDF

39. Association between pre-operative biological phenotypes and postoperative pulmonary complications: An unbiased cluster analysis.

Author

Neto, Ary Serpa, Bos, Lieuwe D., Campos, Pedro P. Z. A., Hemmes, Sabrine N. T., Bluth, Thomas, Calfee, Carolyn S., Ferner, Marion, Güldner, Andreas, Hollmann, Markus W., India, Inmaculada, Kiss, Thomas, Laufenberg-Feldmann, Rita, Sprung, Juraj, Sulemanji, Demet, Unzueta, Carmen, Melo, Marcos F. Vidal, Weingarten, Toby N., Tuip-deBoer, Anita M., Pelosi, Paolo, and de Abreu, Marcelo Gama

Subjects
LUNG disease diagnosis, CLUSTER analysis (Statistics), COMPARATIVE studies, INFLAMMATORY mediators, INTERNATIONAL relations, LUNG diseases, RESEARCH methodology, MEDICAL cooperation, PREOPERATIVE care, RESEARCH, SURGICAL complications, PHENOTYPES, EVALUATION research, POSITIVE end-expiratory pressure
Abstract

Background: Biological phenotypes have been identified within several heterogeneous pulmonary diseases, with potential therapeutic consequences.Objective: To assess whether distinct biological phenotypes exist within surgical patients, and whether development of postoperative pulmonary complications (PPCs) and subsequent dependence of intra-operative positive end-expiratory pressure (PEEP) differ between such phenotypes.Setting: Operating rooms of six hospitals in Europe and USA.Design: Secondary analysis of the 'PROtective Ventilation with HIgh or LOw PEEP' trial.Patients: Adult patients scheduled for abdominal surgery who are at risk of PPCs.Interventions: Measurement of pre-operative concentrations of seven plasma biomarkers associated with inflammation and lung injury.Main Outcome Measures: We applied unbiased cluster analysis to identify biological phenotypes. We then compared the proportion of patients developing PPCs within each phenotype, and associations between intra-operative PEEP levels and development of PPCs among phenotypes.Results: In total, 242 patients were included. Unbiased cluster analysis clustered the patients within two biological phenotypes. Patients with phenotype 1 had lower plasma concentrations of TNF-α (3.8 [2.4 to 5.9] vs. 10.2 [8.0 to 12.1] pg ml; P < 0.001), IL-6 (2.3 [1.5 to 4.0] vs. 4.0 [2.9 to 6.5] pg ml; P < 0.001) and IL-8 (4.7 [3.1 to 8.1] vs. 8.1 [6.0 to 13.9] pg ml; P < 0.001). Phenotype 2 patients had the highest incidence of PPC (69.8 vs. 34.2% in type 1; P < 0.001). There was no interaction between phenotype and PEEP level for the development of PPCs (43.2% in high PEEP vs. 25.6% in low PEEP in phenotype 1, and 73.6% in high PEEP and 65.7% in low PEEP in phenotype 2; P for interaction = 0.503).Conclusion: Patients at risk of PPCs and undergoing open abdominal surgery can be clustered based on pre-operative plasma biomarker concentrations. The two identified phenotypes have different incidences of PPCs. Biologic phenotyping could be useful in future randomised controlled trials of intra-operative ventilation.Trial Registration: The PROtective Ventilation with HIgh or LOw PEEP trial, including the substudy from which data were used for the present analysis, was registered at ClinicalTrials.gov (NCT01441791). [ABSTRACT FROM AUTHOR]

Published
2018
Full Text
View/download PDF

41. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial) : a multicentre randomised controlled trial

Author

Hemmes, Sabrine N. T., de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J., Severgnini, Paolo, Hollmann, Markus W., Binnekade, Jan M., Wrigge, Hermann, Canet, Jaume, Hiesmayr, Michael, Schmid, Werner, Jaber, Samir, Hedenstierna, Göran, Putensen, Christian, Hemmes, Sabrine N. T., de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J., Severgnini, Paolo, Hollmann, Markus W., Binnekade, Jan M., Wrigge, Hermann, Canet, Jaume, Hiesmayr, Michael, Schmid, Werner, Jaber, Samir, Hedenstierna, Göran, and Putensen, Christian

Abstract

Background The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H2O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level of positive end-expiratory pressure with recruitment manoeuvres protects against postoperative pulmonary complications in patients at risk of complications who are receiving mechanical ventilation with low tidal volumes during general anaesthesia for open abdominal surgery. Methods In this randomised controlled trial at 30 centres in Europe and North and South America, we recruited 900 patients at risk for postoperative pulmonary complications who were planned for open abdominal surgery under general anaesthesia and ventilation at tidal volumes of 8 mL/kg. We randomly allocated patients to either a high level of positive end-expiratory pressure (12 cm H2O) with recruitment manoeuvres (higher PEEP group) or a low level of pressure (<= 2 cm H2O) without recruitment manoeuvres (lower PEEP group). We used a centralised computer-generated randomisation system. Patients and outcome assessors were masked to the intervention. Primary endpoint was a composite of postoperative pulmonary complications by postoperative day 5. Analysis was by intention-to-treat. The study is registered at Controlled-Trials. com, number ISRCTN70332574. Findings From February, 2011, to January, 2013, 447 patients were randomly allocated to the higher PEEP group and 453 to the lower PEEP group. Six patients were excluded from the analysis, four because they withdrew consent and two for violation of inclusion criteria. Median levels of positive end-expiratory pressure were 12 cm H2O (IQR 12-12) in the higher PEEP group and 2 cm H2O (0-2) in the lower PEEP group. Postoperative pulmonary complications were reported in 174 (40%

Published
2014
Full Text
View/download PDF

42. Kinetics of plasma biomarkers of inflammation and lung injury in surgical patients with or without postoperative pulmonary complications.

Author

Serpa Neto, Ary, Campos, Pedro P. Z. A., Hemmes, Sabrine N. T., Bos, Lieuwe D., Bluth, Thomas, Ferner, Marion, Güldner, Andreas, Hollmann, Markus W., India, Inmaculada, Kiss, Thomas, Laufenberg-Feldmann, Rita, Sprung, Juraj, Sulemanji, Demet, Unzueta, Carmen, Vidal Melo, Marcos F., Weingarten, Toby N., Tuip-de Boer, Anita M., Pelosi, Paolo, de Abreu, Marcelo Gama, and Schultz, Marcus J.

Abstract

Background: Postoperative pulmonary complications (PPCs) are common after major abdominal surgery. The kinetics of plasma biomarkers could improve identification of patients developing PPCs, but the kinetics may depend on intraoperative ventilator settings.Objective: To test whether the kinetics of plasma biomarkers are capable of identifying patients who will develop PPCs, and whether the kinetics depend on the intraoperative level of positive end-expiratory pressure (PEEP).Design: A preplanned substudy of a randomised controlled trial.Setting: Operation room of five centres.Patients: Two hundred and forty-two adult patients scheduled for abdominal surgery at risk of developing PPCs.Interventions: High (12 cmH2O) versus low (≤2 cmH2O) levels of PEEP.Main Outcome Measures: Individual PPCs were combined as a composite endpoint. Plasma samples were collected before surgery, directly after surgery and on the fifth postoperative day. The levels of the following were measured: tumour necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8, the soluble form of the Receptor for Advanced Glycation End-products (sRAGE), Surfactant Protein (SP)-D, Clara Cell protein (CC)-16 and Krebs von den Lungen 6 (KL6).Results: Blood sampling was complete in 242 patients: 120 patients in the high PEEP group and 122 patients in the low PEEP group. Increases in plasma levels of TNF- IL-6, IL-8 and CC-16, and a decrease in plasma levels of SP-D were greater in patients who developed PPCs; however, the area under the receiver operating characteristic curve was low for all biomarkers. CC-16 was the only biomarker whose level increased more in patients who had received high levels of PEEP.Conclusion: In patients undergoing abdominal surgery and at risk of developing PPCs, plasma levels of biomarkers for inflammation or lung injury showed distinct kinetics with development of PPCs, but none of the biomarkers showed sufficient prognostic value. The use of high levels of PEEP was associated with increased levels of CC-16, suggesting lung overdistension.Trial Registration: The PROVHILO trial, including this substudy, was registered at clinicaltrials.gov (NCT01441791). [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

44. Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery

Author

Hemmes, Sabrine N. T., Severgnini, Paolo, Jaber, Samir, Canet, Jaume, Wrigge, Hermann, Hiesmayr, Michael, Tschernko, Edda M., Hollmann, Markus W., Binnekade, Jan M., Hedenstierna, Göran, Putensen, Christian, de Abreu, Marcelo Gama, Pelosi, Paolo, Schultz, Marcus J., Hemmes, Sabrine N. T., Severgnini, Paolo, Jaber, Samir, Canet, Jaume, Wrigge, Hermann, Hiesmayr, Michael, Tschernko, Edda M., Hollmann, Markus W., Binnekade, Jan M., Hedenstierna, Göran, Putensen, Christian, de Abreu, Marcelo Gama, Pelosi, Paolo, and Schultz, Marcus J.

Abstract

Background: Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP) and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery. Methods: The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO") trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH(2)O with recruitment maneuvers (the lung-protective strategy) or mechanical ventilation with the level of PEEP at maximum 2 cmH(2)O without recruitment maneuvers (the conventional strategy). The primary endpoint is any post-operative pulmonary complication. Discussion: The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications.

Published
2011
Full Text
View/download PDF

46. Protective versus Conventional Ventilation for Surgery.

Author

Neto, Ary Serpa, Hemmes, Sabrine N. T., Barbas, Carmen S. V., Beiderlinden, Martin, Biehl, Michelle, Binnekade, Jan M., Canet, Jaume, Fernandez-Bustamante, Ana, Futier, Emmanuel, Gajic, Ognjen, Hedenstierna, Göran, Hollmann, Markus W., Jaber, Samir, Kozian, Alt, Licker, Marc, Wen-Qian Lin, Maslow, Andrew D., Memtsoudis, Stavros G., Miranda, Dinis Reis, and Moine, Pierre

Published
2015
Full Text
View/download PDF

47. Rationale and study design of PROVHILO - a worldwide multicenter randomized controlled trial on protective ventilation during general anesthesia for open abdominal surgery.

Author

Hemmes, Sabrine NT, Severgnini, Paolo, Jaber, Samir, Canet, Jaume, Wrigge, Hermann, Hiesmayr, Michael, Tschernko, Edda M., Hollmann, Markus W., Binnekade, Jan M., Hedenstierna, Göran, Putensen, Christian, Abreu, Marcelo Gama de, Pelosi, Paolo, Schultz, Marcus J., Hemmes, Sabrine N T, Hedenstierna, Göran, and de Abreu, Marcelo Gama

Subjects
RANDOMIZED controlled trials, ABDOMINAL surgery, ENDOSCOPIC surgery, ANESTHESIA, CLINICAL trials
Abstract

Background: Post-operative pulmonary complications add to the morbidity and mortality of surgical patients, in particular after general anesthesia >2 hours for abdominal surgery. Whether a protective mechanical ventilation strategy with higher levels of positive end-expiratory pressure (PEEP) and repeated recruitment maneuvers; the "open lung strategy", protects against post-operative pulmonary complications is uncertain. The present study aims at comparing a protective mechanical ventilation strategy with a conventional mechanical ventilation strategy during general anesthesia for abdominal non-laparoscopic surgery.Methods: The PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure ("PROVHILO") trial is a worldwide investigator-initiated multicenter randomized controlled two-arm study. Nine hundred patients scheduled for non-laparoscopic abdominal surgery at high or intermediate risk for post-operative pulmonary complications are randomized to mechanical ventilation with the level of PEEP at 12 cmH(2)O with recruitment maneuvers (the lung-protective strategy) or mechanical ventilation with the level of PEEP at maximum 2 cmH(2)O without recruitment maneuvers (the conventional strategy). The primary endpoint is any post-operative pulmonary complication.Discussion: The PROVHILO trial is the first randomized controlled trial powered to investigate whether an open lung mechanical ventilation strategy in short-term mechanical ventilation prevents against postoperative pulmonary complications.Trial Registration: ISRCTN: ISRCTN70332574. [ABSTRACT FROM AUTHOR]

Published
2011
Full Text
View/download PDF

49. Authors' reply.

Author

Hemmes, Sabrine N. T., Gama de Abreu, Marcelo, Pelosi, Paolo, and Schultz, Marcus J.

Subjects
*POSITIVE end-expiratory pressure, *GENERAL anesthesia, *ABDOMINAL surgery
Abstract

A response from the authors of the article "High Versus Low Positive End-Expiratory Pressure During General Anaesthesia for Open Abdominal Surgery (PROVHILO trial: A Multicentre Randomised Controlled Trial," in the August 9, 2014 issue is presented.

Published
2014
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results