The final day of Euroanaesthesia saw the online publication in the Journal of the American Medical Association (JAMA) of research from the ESA’s Clinical Trials Network (CTN) group.
The study “Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients” was written by the PROBESE Collaborative group of the PROtective Ventilation Network, including Professor Marcelo Gama de Abreu, University Hospital Carl Gustav Carus and Technical University of Dresden, Germany, and colleagues.
The study aimed to determine if a high level of PEEP with alveolar recruitment maneuvers decreases postoperative pulmonary complications in obese patients undergoing surgery compared with lower level PEEP.
Among 2013 adults who were randomised, 1976 (98.2%) completed the trial (mean age, 48.8 years; 1381 [69.9%] women; 1778 [90.1%] underwent abdominal operations). In the intention-to-treat analysis, the primary outcome occurred in 211 of 989 patients (21.3%) in the high level of PEEP group compared with 233 of 987 patients (23.6%) in the low level of PEEP group (difference,−2.3% [95%CI,−5.9% to1.4% ]; risk ratio, 0.93 [95%CI, 0.83 to 1.04]; P=0.23).
Among the 9 prespecified secondary outcomes, 6 were not significantly different between the high and low level of PEEP groups, and 3 were significantly different, including fewer patients with hypoxemia (5.0% in the high level of PEEP group vs 13.6% in the low level of PEEP group; difference,−8.6% [95%CI,−11.1% to 6.1%]; P<.001).
The authors concluded: “Among obese patients undergoing surgery under general anaesthesia, an intraoperative mechanical ventilation strategy with a higher level of PEEP and alveolar recruitment maneuvers, compared with a strategy with a lower level of PEEP, did not reduce postoperative pulmonary complications.”
To see the full abstract of this study, click here