Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22118
Title: Low tidal volume ventilation during anaesthesia for major surgery: protocol and statistical analysis plan.
Austin Authors: Karalapillai, Dharshi ;Weinberg, Laurence ;Peyton, Philip J ;Ellard, Louise ;Hu, Raymond;Pearce, Brett ;Tan, Chong;Story, David A ;ODonnell, Mark;Hamilton, Patrick;Oughton, Chad;Galtieri, Jonathan;Wilson, Anthony;Neto, Ary Serpa;Eastwood, Glenn M ;Bellomo, Rinaldo ;Jones, Daryl A 
Affiliation: Department of Anaesthesia, University of Melbourne, Melbourne, VIC, Australia
Department of Intensive Care, Austin Health, Heidelberg, Victoria, Australia
Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Dec-2019
Publication information: Critical Care and Resuscitation 2019; 21(4): 243-50
Abstract: Mechanical ventilation is mandatory in patients undergoing general anaesthesia for major surgery. Tidal volumes higher than 10 mL/kg of predicted body weight have been advocated for intraoperative ventilation, but recent evidence suggests that low tidal volumes may benefit surgical patients. To date, the impact of low tidal volume compared with conventional tidal volume during surgery has only been assessed in clinical trials that also combine different levels of positive end-expiratory pressure (PEEP) in each arm. We aimed to assess the impact of low tidal volume compared with conventional tidal volume during general anaesthesia for surgery on the incidence of postoperative respiratory complications in adult patients receiving moderate levels of PEEP. Single-centre, two-arm, randomised clinical trial. In total, 1240 adult patients older than 40 years scheduled for at least 2 hours of surgery under general anaesthesia and routinely monitored with an arterial line were included. Patients were ventilated intraoperatively with a moderate level of PEEP (5 cmH2O) and randomly assigned to tidal volume of 6 mL/kg predicted body weight (low tidal volume) or 10 mL/kg predicted body weight (conventional tidal volume in Australia). The primary outcome is the occurrence of postoperative respiratory complications, recorded as a composite endpoint of adverse respiratory events during the first 7 postoperative days. This is the first well powered study comparing the effect of low tidal volume ventilation versus high tidal volume ventilation during surgery on the incidence of postoperative respiratory complications in adult patients receiving moderate levels of PEEP. Australian New Zealand Clinical Trials Registry (ACTRN12614000790640).
URI: http://ahro.austin.org.au/austinjspui/handle/1/22118
ORCID: 0000-0001-7403-7680
0000-0003-1185-2869
0000-0002-1650-8939
PubMed URL: 31778630
ISSN: 1441-2772
Type: Journal Article
Appears in Collections:Journal articles

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