Sex difference and intra-operative tidal volume (CROSBI ID 310920)
Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija
Podaci o odgovornosti
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. ; for the LAS VEGAS study investigators, the PROVE Network and the Clinical Trial Network of the European Society of Anaesthesiology
LAS VEGAS study investigators ; PROVE Network ; Clinical Trial Network of the European Society of Anaesthesiology
engleski
Sex difference and intra-operative tidal volume
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.
LAS VEGAS ; Mechanical ventilation
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Podaci o izdanju
38 (10)
2021.
1034-1041
objavljeno
0265-0215
1365-2346
10.1097/eja.0000000000001476
Povezanost rada
Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje), Kliničke medicinske znanosti