Academic Journal
Positive End-Expiratory Pressure, Tidal Volume, and Fraction of Inspired Oxygen During General Anaesthesia in High-Risk Patients-A Randomised Clinical Feasibility Trial.
| Τίτλος: | Positive End-Expiratory Pressure, Tidal Volume, and Fraction of Inspired Oxygen During General Anaesthesia in High-Risk Patients-A Randomised Clinical Feasibility Trial. |
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| Συγγραφείς: | Pælestik MB; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Risager BH; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Mortensen SØ; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Schjørring OL; Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Bisgaard J; Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Berthelsen KG; Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark., Balsløv R; Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark., Bach L; Department of Operation and Intensive Care, Randers Regional Hospital, Randers, Denmark., Pælestik KB; Department of Operation and Intensive Care, Randers Regional Hospital, Randers, Denmark., Rossau JGR; Department of Operation and Intensive Care, Randers Regional Hospital, Randers, Denmark., Poulsen C; Department of Operation and Intensive Care, Randers Regional Hospital, Randers, Denmark., Sølling C; Department of Operation and Intensive Care, Viborg Regional Hospital, Viborg, Denmark., Sørensen JT; Department of Operation and Intensive Care, Viborg Regional Hospital, Viborg, Denmark., Enevoldsen M; Department of Operation and Intensive Care, Viborg Regional Hospital, Viborg, Denmark., Petersen LDD; Department of Operation and Intensive Care, Viborg Regional Hospital, Viborg, Denmark., Zwisler ST; Department of Anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark., Brahe NM; Department of Anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark., Rasmussen AM; Department of Anaesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark., Guldberg IA; Department of Anaesthesiology and Intensive Care, Zealand University Hospital, Køge, Denmark., Joost MA; Department of Anaesthesiology and Intensive Care, Zealand University Hospital, Køge, Denmark., Nielsen HB; Department of Anaesthesiology and Intensive Care, Zealand University Hospital, Køge, Denmark.; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Espelund US; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Horsens Regional Hospital, Horsens, Denmark., Brix LD; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Horsens Regional Hospital, Horsens, Denmark., Petersen JAK; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Eriksen CF; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Kjærgaard AG; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Dinesen PD; Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark., Abildgren ML; Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Aalborg, Denmark., Vallentin MF; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.; Prehospital Emergency Medical Services, Central Denmark Region, Aarhus, Denmark., Jessen MK; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Vistisen ST; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Nørholt CH; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Baltsen CD; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Andersen LK; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Hansen FG; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Frilund LW; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Winther S; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Granfelt A; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark., Andersen LW; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.; Prehospital Emergency Medical Services, Central Denmark Region, Aarhus, Denmark. |
| Πηγή: | Acta anaesthesiologica Scandinavica [Acta Anaesthesiol Scand] 2026 Sep; Vol. 70 (8), pp. e70309. |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial; Multicenter Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 0370270 Publication Model: Print Cited Medium: Internet ISSN: 1399-6576 (Electronic) Linking ISSN: 00015172 NLM ISO Abbreviation: Acta Anaesthesiol Scand Subsets: MEDLINE |
| Imprint Name(s): | Publication: Oxford, UK : Wiley-Blackwell Original Publication: Aarhus, Denmark : Universitetsforlaget, 1957- |
| Ιατρικοί όροι (MeSH): | Positive-Pressure Respiration*/methods , Anesthesia, General*/methods , Oxygen*/administration & dosage , Tidal Volume*, Postoperative Complications/epidemiology ; Humans ; Female ; Feasibility Studies ; Male ; Aged ; Middle Aged ; Length of Stay ; Adult |
| Περίληψη: | Background: Optimal ventilatory settings during general anaesthesia are unknown. The goal of this trial was to test different ventilatory settings and blood pressure targets during general anaesthesia. This manuscript focuses on the ventilatory interventions. Methods: This was a multicentre, randomised factorial trial conducted at eight hospitals in Denmark. Four hundred and eighty-three patients ASA 3-5, scheduled for major surgery under general anaesthesia, were included. Patients were randomised to positive end-expiratory pressure (PEEP) of 5, 8, or 10 cm H Results: Feasibility goals were not met, but clear separation within each intervention was achieved. There were no differences between groups in most postoperative outcomes. Cardiac arrhythmias appeared more frequently in the PEEP-8- and 10-cm-H Conclusion: Adherence to interventions was acceptable, although below feasibility goals. Few postoperative complications were more frequent in patients receiving PEEP 8 and 10, and in patients receiving FiO Trial Registration: Clinicaltrials.gov: NCT06047119. (© 2026 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.) |
| References: | M. Bolther, J. Henriksen, M. J. Holmberg, et al., “Ventilation Strategies During General Anesthesia for Noncardiac Surgery: A Systematic Review and Meta‐Analysis,” Anesthesia and Analgesia 135 (2022): 971–985. M. Høybye, P. C. Lind, M. J. Holmberg, et al., “Fraction of Inspired Oxygen During General Anesthesia for Non‐Cardiac Surgery: Systematic Review and Meta‐Analysis,” Acta Anaesthesiologica Scandinavica 66 (2022): 923–933. M. B. Pælestik, B. H. Risager, S. Ø. Mortensen, et al., “Blood Pressure Targets During General Anaesthesia in High‐Risk Patients‐A Randomised Clinical Feasibility Trial,” Acta Anaesthesiologica Scandinavica 70, no. 8 (2026): e70315, https://doi.org/10.1111/aas.70315. [Correction added on 12 August 2026, after first online publication: This reference and its in‐text citations have been updated in this version.]. P. A. Harris, R. Taylor, R. Thielke, J. Payne, N. Gonzalez, and J. G. Conde, “Research Electronic Data Capture (REDCap)—A Metadata‐Driven Methodology and Workflow Process for Providing Translational Research Informatics Support,” Journal of Biomedical Informatics 42 (2009): 377–381. P. A. Harris, R. Taylor, B. L. Minor, et al., “The REDCap Consortium: Building an International Community of Software Platform Partners,” Journal of Biomedical Informatics 95 (2019): 103208. R. G. Brower, M. A. Matthay, A. Morris, D. Schoenfeld, B. T. Thompson, and A. Wheeler, “Ventilation With Lower Tidal Volumes as Compared With Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress Syndrome,” New England Journal of Medicine 342 (2000): 1301–1308. I. Jammer, N. Wickboldt, M. Sander, et al., “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,” European Journal of Anaesthesiology 32 (2015): 88–105. S. N. Hemmes, M. Gama de Abreu, P. Pelosi, M. J. Schultz, and Anaesthesiology PNIftCTNotESo, “High Versus Low Positive End‐Expiratory Pressure During General Anaesthesia for Open Abdominal Surgery (PROVHILO Trial): A Multicentre Randomised Controlled Trial,” Lancet 384 (2014): 495–503. A. Turan, W. A. S. Esa, E. Rivas, et al., “Tidal Volume and Positive End‐Expiratory Pressure and Postoperative Hypoxemia During General Anesthesia: A Single Center Multiple Cross‐Over Factorial Cluster Trial,” Anesthesiology 137 (2022): 406–417. F. X. Whalen, O. Gajic, G. B. Thompson, et al., “The Effects of the Alveolar Recruitment Maneuver and Positive End‐Expiratory Pressure on Arterial Oxygenation During Laparoscopic Bariatric Surgery,” Anesthesia and Analgesia 102 (2006): 298–305. D. Karalapillai, L. Weinberg, P. Peyton, et al., “Effect of Intraoperative Low Tidal Volume vs Conventional Tidal Volume on Postoperative Pulmonary Complications in Patients Undergoing Major Surgery: A Randomized Clinical Trial,” JAMA 324 (2020): 848–858. E. Futier, J. M. Constantin, C. Paugam‐Burtz, et al., “A Trial of Intraoperative Low‐Tidal‐Volume Ventilation in Abdominal Surgery,” New England Journal of Medicine 369 (2013): 428–437. D. Huang, S. Zhou, Z. Yu, J. Chen, and H. Xie, “Lung Protective Ventilation Strategy to Reduce Postoperative Pulmonary Complications (PPCs) in Patients Undergoing Robot‐Assisted Laparoscopic Radical Cystectomy for Bladder Cancer: A Randomized Double Blinded Clinical Trial,” Journal of Clinical Anesthesia 71 (2021): 110156. M. Qadan, C. Battista, S. A. Gardner, G. Anderson, O. Akca, and H. C. Polk, “Oxygen and Surgical Site Infection: A Study of Underlying Immunologic Mechanisms,” Anesthesiology 113 (2010): 369–377. P. B. Dauwe, B. J. Pulikkottil, L. Lavery, J. M. Stuzin, and R. J. Rohrich, “Does Hyperbaric Oxygen Therapy Work in Facilitating Acute Wound Healing: A Systematic Review,” Plastic and Reconstructive Surgery 133 (2014): 208e–215e. X. F. Li, D. Jiang, Y. L. Jiang, et al., “Comparison of Low and High Inspiratory Oxygen Fraction Added to Lung‐Protective Ventilation on Postoperative Pulmonary Complications After Abdominal Surgery: A Randomized Controlled Trial,” Journal of Clinical Anesthesia 67 (2020): 110009. |
| Grant Information: | Danmarks Frie Forskningsfond; Kræftens Bekæmpelse; Knud og Edith Eriksens Mindefond; Else og Mogens Wedell Wedellsborgs Fond |
| Contributed Indexing: | Keywords: PEEP; clinical trial; feasibility; general anesthesia; outcomes; oxygen; tidal volume |
| Molecular Sequence: | ClinicalTrials.gov NCT06047119 |
| Substance Nomenclature: | S88TT14065 (Oxygen) |
| Entry Date(s): | Date Created: 20260727 Date Completed: 20260728 Latest Revision: 20260819 |
| Update Code: | 20260819 |
| PubMed Central ID: | PMC13406914 |
| DOI: | 10.1111/aas.70309 |
| PMID: | 42508987 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1399-6576 |
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| DOI: | 10.1111/aas.70309 |