Ventilation Method Cuts Postop Problems
A lung-protective method of ventilation improved outcomes for patients who had an intermediate-to-high risk of pulmonary complications before undergoing major abdominal surgery, a randomized trial showed.
Compared with standard ventilation, ventilation using positive end-expiratory pressure (PEEP) and a lower tidal volume significantly reduced the occurrence of major pulmonary or extra-pulmonary complications in the first postoperative week (10.5% versus 27.5%; RR 0.40, 95% CI 0.24-0.68), according to Samir Jaber, MD, PhD, of the Centre Hospitalier Universitaire de Montpellier in France, and colleagues.
Patients who received lung-protective ventilation also spent a median of 2.45 fewer days (95% CI 0.72-4.17) in the hospital, the researchers reported in the Aug. 1 issue of the New England Journal of Medicine.
The mortality rate at 30 days, however, was not significantly different between the lung-protective and standard ventilation groups (3% versus 3.5%). The lack of a mortality benefit with lung-protective ventilation has been seen in prior studies.