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| Name | Class |
|---|---|
| Aalborg University | OTHER |
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Pulmonary postoperative complications (PPC) are among the main causes of surgical complications affecting both postoperative morbidity and mortality. Little is known about the effect of intraoperative VQ mismatch on the occurrence of PPC. In this trial the investigators will evaluate if intraoperative VQ mismatch may predict PPC in a population of patients undergoing major surgery.
Pulmonary postoperative complications (PPC) are among the main causes of surgical complications affecting both postoperative morbidity and mortality. Little is known about the effect of intraoperative VQ mismatch on the occurrence of PPC.
PPC are classically considered associated to the occurrence of intraoperative atelectasis, and therefore to the development of a certain amount of shunt, but this concept have been recently questioned.
Recent studies showed indeed that, despite age is one of the main determinants of PPCs, increasing age is not associated to the increase of intraoperative shunt. Shunt therefore may not be the main determinant of PPC.
In this trial the investigators will evaluate if other causes of intraoperative VQ mismatch (e.g. low V/Q, high V/Q, dead space) may predict PPC in a population of patients undergoing major surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients undergoing surgery | Mechanical measures, VQ mismatch evaluation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Measure of ventilation/perfusion (V/Q) mismatch using Beacon ALPE (Automatic Lung Paramether Estimator) | Device | Evaluation of intraoperative V/Q mismatch using the Beacon ALPE during anesthesia. |
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of Pulmonary postoperative complications | Definition derived from the ESA-ESICM joined taskforce on perioperative outcome measures. | In the first 7 days after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative mechanical measures (pressures) | Intraoperative evaluation of:
| During surgery |
| Intraoperative drug administration |
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Inclusion Criteria:
Exclusion Criteria:
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Patients undergoing general anesthesia for elective major surgery (non-thoracic).
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| Name | Affiliation | Role |
|---|---|---|
| Savino Spadaro, MD, PhD | Università degli Studi di Ferrara | Study Director |
| Gaetano Scaramuzzo, MD | Università degli Studi di Ferrara | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Azienda Ospedaliero Universitaria Sant'Anna | Ferrara | 44121 | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31045901 | Background | Hedenstierna G, Tokics L, Scaramuzzo G, Rothen HU, Edmark L, Ohrvik J. Oxygenation Impairment during Anesthesia: Influence of Age and Body Weight. Anesthesiology. 2019 Jul;131(1):46-57. doi: 10.1097/ALN.0000000000002693. | |
| 28186222 | Background | Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth. 2017 Mar 1;118(3):317-334. doi: 10.1093/bja/aex002. |
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Evalation of anesthetic drugs administered during surgery by the treating physician.
| During surgery |
| Intraoperative arterial pressure | Evaluation during surgery of:
| During surgery |
| Intraoperative heart rate | evaluation of - Heart rate (beats/min) | During surgery |
| V/Q mismatch | Evaluation of V/Q mismatch | During anesthesia |
| fluid balance | Evaluation of patients fluid intake and fluid balance during surgery | During surgery |
| 32816177 | Background | Spadaro S, Grasso S, Karbing DS, Santoro G, Cavallesco G, Maniscalco P, Murgolo F, Di Mussi R, Ragazzi R, Rees SE, Volta CA, Fogagnolo A. Physiological effects of two driving pressure-based methods to set positive end-expiratory pressure during one lung ventilation. J Clin Monit Comput. 2021 Oct;35(5):1149-1157. doi: 10.1007/s10877-020-00582-z. Epub 2020 Aug 20. |
| 25058504 | Background | Jammer I, Wickboldt N, Sander M, Smith A, Schultz MJ, Pelosi P, Leva B, Rhodes A, Hoeft A, Walder B, Chew MS, Pearse RM; European Society of Anaesthesiology (ESA) and the European Society of Intensive Care Medicine (ESICM); European Society of Anaesthesiology; European Society of Intensive Care Medicine. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol. 2015 Feb;32(2):88-105. doi: 10.1097/EJA.0000000000000118. |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D053120 | Respiratory Aspiration |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D010477 | Perfusion |
| ID | Term |
|---|---|
| D008919 | Investigative Techniques |
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