2023

An Anesthesia-centered Bundle to Reduce Postoperative Pulmonary Complications: the PRIME-AIR Study Protocol

PLoS One 2023 Vol. 18 Issue 4 Pages e0283748

DOI: 10.1371/journal.pone.0283748. PMCID: PMC10079125

DISCUSSION: Participant recruitment for this study started in January 2020; results are expected in 2024. At the conclusion of this trial, we will determine if this anesthesia-centered strategy focused on perioperative lung expansion reduces lung morbidity and healthcare utilization after open abdominal surgery.

2020

Individualized PEEP to Optimise Respiratory Mechanics During Abdominal Surgery: a Pilot Randomised Controlled Trial

Br J Anaesth 2020 Vol. 125 Issue 3 Pages 383-392

DOI: 10.1016/j.bja.2020.06.030. PMCID: PMC7497030

CONCLUSIONS: This pilot study suggests that individualised PEEP management strategies applied during abdominal surgery reduce driving pressure, maintain positive P(tp_ee), and increase static compliance. The wide range of PEEP observed suggests that an individualised approach is required to optimise respiratory mechanics during abdominal surgery.

2017

Postoperative Pulmonary Complications, Early Mortality, and Hospital Stay Following Noncardiothoracic Surgery: a Multicenter Study by the Perioperative Research Network Investigators

JAMA Surg 2017 Vol. 152 Issue 2 Pages 157-166

DOI: 10.1001/jamasurg.2016.4065. PMCID: PMC5334462 DOI: 10.1001/jamasurg.2016.4065

CONCLUSIONS: Postoperative pulmonary complications are common in patients with American Society of Anesthesiologists physical status 3, despite current protective ventilation practices. Even mild PPCs are associated with increased early postoperative mortality, ICU admission, and length of stay (ICU and hospital). Mild frequent PPCs (e.g., atelectasis and prolonged oxygen therapy need) deserve increased attention and intervention for improving perioperative outcomes.