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Effect of intraoperative PEEP with recruitment maneuvers on the occurrence of postoperative pulmonary complications during general anesthesia--protocol for Bayesian analysis of three randomized clinical trials of intraoperative ventilation.

Effect of intraoperative PEEP with recruitment maneuvers on the occurrence of postoperative pulmonary complications during general anesthesia--protocol for Bayesian analysis of three randomized clinical trials of intraoperative ventilation.

Fecha de publicación: 23/06/2023 Fecha Ahead of Print: 23/06/2023

Autores de IIS La Fe

Guido Mazzinari

Autor
Julian Librero Lopez

Autor

Participantes ajenos a IIS La Fe

Zampieri FG
Ball L
Campos NS
Bluth T
Hemmes SNT
Ferrando C
Soro M
Pelosi P
Gama de Abreu M
Schultz MJ
Serpa Neto A
PROVHILO investigators
iPROVE investigators
PROBESE investigators
PROVE network investigators

Grupos

Medicina Perioperatoria, Anestesiología y Reanimación

Leader

Óscar Díaz Cambronero

Abstract

Background: Using the frequentist approach, a recent meta-analysis of three randomized clinical trials in patients undergoing intraoperative ventilation during general anesthesia for major surgery failed to show the benefit of ventilation that uses high positive end-expiratory pressure with recruitment maneuvers when compared to ventilation that uses low positive end-expiratory pressure without recruitment maneuvers. Methods: We designed a protocol for a Bayesian analysis using the pooled dataset. The multilevel Bayesian logistic model will use the individual patient data. Prior distributions will be prespecified to represent a varying level of skepticism for the effect estimate. The primary endpoint will be a composite of postoperative pulmonary complications (PPC) within the first seven postoperative days, which reflects the primary endpoint of the original studies. We preset a range of practical equivalence to assess the futility of the intervention with an interval of odds ratio (OR) between 0.9 and 1.1 and assess how much of the 95% of highest density interval (HDI) falls between the region of practical equivalence. Ethics and dissemination: The used data derive from approved studies that were published in recent years. The findings of this current analysis will be reported in a new manuscript, drafted by the writing committee on behalf of the three research groups. All investigators listed in the original trials will serve as collaborative authors.

Datos de la publicación

ISSN/ISSNe:: 2046-1402, 2046-1402
Tipo:: Article
Páginas:: 1090-1090
DOI:: 10.12688/f1000research.125861.1
Factor de Impacto:: 0,939 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Mazzinari G:: Instituto de Investigación. Perioperative Medicine, Instituto de Investigación Sanitaria la Fe, Valencia, Spain, 46026, Spain

Anesthesiology, Hospital Universitario y Politécnico la Fe, Valencia, Spain, 46026, Spain
Zampieri FG:: Academic Research Organization, Albert Einstein Hospital, Sao Paulo, Brazil
Ball L:: Surgical sciences and integrated diagnostics, University of Genoa, Genoa, Italy

IRCCS Policlinico San Martino, Genoa, Italy
Campos NS:: Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil

Cardio pulmonary department, Instituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidad de de Sao Paulo, Sao Paulo, Brazil
Bluth T:: Pulmonary Engineergin group, Anesthesiology and intensive Care, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
Ferrando C:: CIBER (Center of Biomedical Research in Respiratory Diseases, Instituto de Salud Carlos III, Madrid, Spain

Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Institut D'investigació August Pi i Sunyer, Barcelona, Spain
Librero J:: Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Pamplona, Spain
Soro M:: INCLIVA Clinical Research Institute, Hospital Clinico Universitario de Valencia, Valencia, Spain
Pelosi P:: Surgical sciences and integrated diagnostics, University of Genoa, Genoa, Italy

IRCCS Policlinico San Martino, Genoa, Italy
Gama de Abreu M:: Pulmonary Engineergin group, Anesthesiology and intensive Care, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
Schultz MJ:: Nuffield Department of Medicine, University of Oxford, Oxford, UK

Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of tropical medicine, Mahidol University, Bangkok, Thailand
Serpa Neto A:: Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Australia

Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, Australia

Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil

Cardio pulmonary department, Instituto do Coração, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidad de de Sao Paulo, Sao Paulo, Brazil