Ventilation and outcomes following robotic-assisted abdominal surgery: an international, multicentre observational study

Costa, Luis Guilherme V. da; Pelosi, Paolo; Abreu, Marcelo Gama de; Canet, Jaume; Cata, Juan P.; Costa, Luiz Guilherme Villares da; Baerdemaeker, Luc De; Gottumukkala, Vijay; Hemmes, Sabrine N.T.; Hollmann, Markus W.; Matot, Idit; Mazzinari, Guido; Queiroz, Verônica Neves Fialho; Schultz, Marcus J.; Neto, Ary Serpa; Šprung, Juraj; Takaoka, Flavio; Agarwala, Aalok V.; Akeroyd, Louise; Andorlini, F; Anicetti, Lisa; Antonelli, Massimo; Arantes, Bruno S.; Irujo, J.J. Ariño; Artsi, Hanna; Babian, Renata; Barbosa, Rogerio Póvoa; Barker, D; Basagni, Diletta; Basso, Nicola; Beltrán, Joan; Bocciero, Vittorio; Bonatti, Giulia; Boriati, Ernesto; Bravo, Mauro; Brazzi, Luca; Brearton, Chris; Brennan, Andrew; Bulinski, Adam M.; Cafagna, Sara; Cardoni, Andrea; Mora, Paula Castelló; César, Daniel S; Chaves, R.C.F.; Chen, Lee‐lynn; Chukkambotla, Srikanth; Ciccozzi, Alessandra; Cilia, Danae; Cope, Sean; D’Orto, Ulisses C.; Dalton, Claire; Davi, Alessandra; Bonis, Marina del Barrio De; Gaudio, Angelo Raffaele De; Luca, Lucilla De; Delgado, Carlos; Deljou, Atousa; Ruscio, Cecilia Di; Droger, Sijgje M.; Duberley, Stephen; Eidelman, Leonid A.; Evans, Alison; Fabiani, Constanza; Fasciano, Umberto; Firth-Gieben, Jennifer; Fitchett, Jillian; Fundarò, Angela; Galdi, J.R.; Gallo, Verdiana; Gavagni, Mattia; Graham, Chris; Gil, Manuel Granell; Gratarola, Angelo; Grillandini, Chiara; Groeben, Harald-Thomas; Ismail, Nesrine Ben; Jacob, Reni; Jones, Chris; Jones, Rebecca; Kalmar, Alain; Kapoor, Ritoo; Kelliher, Leigh; Köhne, Wiebke; Koopman, Joseph S.H.A.; Lanka, Prasad; Lee, Jae Woo; Liban, B.; Livi, Francesca; Mariano, Renato; Plumed, Ruth Martínez; Mazzella, Marta; McClure, Stewart; McMonagle, Martina; Mills, Gary H.; Mirabella, Lucia; Monsalve, C.; Moon, Angela; Morchio, Laura; Morris, Frances; Motroni, Lorenzo; Mura, Benedetta; Nerini, Alessandro; Sonna, Elodia C. Noumedem; Oakes, N.; Orlandi, Marina; Paladini, Antonella; Patil, Anita; Patil, Vishal; Patrone, Valentina; Pinder, Angela; Piroli, Alba; Posso, I.P.; Queiroz, Veronica N.F.; Rabbu, Yosef S.; Robert, René; Romagnoli, Stefano; Ronen, Ariel; Rothman, Felipe; Rusagara, Patrick; Russo, A.; Sabov, Moldovan; Saitta, Thomas; Shah, Nirav; Smith, Neil; Sollazzi, Liliana; Stewart, Emma; Stones, Elizabeth; Storton, Kim; Tena, Beatriz; Terreni, Eleonora; Teruya, Alexandre; Travaglia, Chiara; Treschan, Tanja A.; Vanoverschelde, Henk; Venkatesh, Harish; Melo, Marcos F. Vidal; Villa, Gianluca; Vossen, R.; Webber, Stephen; Weingarten, Toby N.; Willcocks, Matt; Winslow, Luke; Woods, Lindsey

doi:10.1016/j.bja.2020.08.058

Cited by 13 publications

(2 citation statements)

References 21 publications

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“…When the surgical field is close to the thorax as in thoracic or abdominal surgery, the airway pressure could differ dynamically depending on the surgical procedure. Thus, it is difficult to actually estimate the pressure generated from the external lung and assume driving pressure as a surrogate parameter of transpulmonary pressure 32 . Because the majority surgical fields were not close to the thorax in the current study, driving pressure was thought to better represent transpulmonary pressure in a better environment to evaluate the real association between driving pressure and PPC risk.…”

Section: Discussionmentioning

confidence: 99%

The impact of driving pressure on postoperative pulmonary complication in patients with different respiratory spirometry

Kim

Park

et al. 2022

Sci Rep

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Risk factors for postoperative pulmonary complication (PPC) have not been determined according to preoperative respiratory spirometry. Thus, we aimed to find contributors for PPC in patients with restrictive or normal spirometric pattern. We analyzed 654 patients (379 with normal and 275 with restrictive spirometric pattern). PPCs comprised respiratory failure, pleural effusion, atelectasis, respiratory infection, and bronchospasm. We analyzed the association between perioperative factors and PPC using binary logistic regression. In particular, we conducted subgroup analysis on the patients stratified according to preoperative spirometry. Of 654 patients, 27/379 patients (7.1%) with normal spirometric pattern and 33/275 patients (12.0%) with restrictive spirometric pattern developed PPCs. Multivariable analysis demonstrated that high driving pressure was the only intraoperative modifiable factor increasing PPC risk (OR = 1.13 [1.02–1.25], p = 0.025). In the subgroup of patients with restrictive spirometric pattern, intraoperative driving pressure was significantly associated with PPC (OR = 1.21 [1.05–1.39], p = 0.009), whereas driving pressure was not associated with PPC in patients with normal spirometric pattern (OR = 1.04 [0.89–1.21], p = 0.639). In patients with restrictive spirometric pattern, greater intraoperative driving pressure is significantly associated with increased PPC risk. In contrast, intraoperative driving pressure is not associated with PPC in patients with normal spirometric pattern.

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Section: Discussionmentioning

confidence: 99%

The impact of driving pressure on postoperative pulmonary complication in patients with different respiratory spirometry

Kim

Park

et al. 2022

Sci Rep

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“…In considering the Assessment of Ventilation during general AnesThesia for Robotic surgery (AVATaR) study published in the British Journal of Anaesthesia, 1 we would like to reflect on the definition and clinical relevance of postoperative complications after abdominal robot-assisted surgery. Queiroz and colleagues 1 performed this substantial multicentre prospective clinical trial assessing postoperative pulmonary complications (PPCs) in 905 abdominal robot-assisted surgical patients from 34 hospitals in nine countries. They concluded that PPCs occur frequently (20%) in the first 5 days after abdominal robot-assisted surgery, are not associated with perioperative ventilator parameters, but are associated with a longer hospital stay.…”

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confidence: 99%