Local Assessment of Ventilatory Management During General Anesthesia for Surgery

Conditions

Anaesthesia, Lung Injury, Pneumonia, Pneumothorax, Respiratory Distress Syndrome, Adult, Respiratory Insufficiency, Surgery, Ventilator-Induced Lung Injury

Keywords

Ventilatory Management, Mechanical Ventilation, Post Operative pulmonary complications, Intra-operative complications, General Anesthesia, Surgery, LAS VEGAS, ESA (European Society of Anaesthesiology), European Society of Anaesthesiology

Brief summary

Objectives 1. To characterize mechanical ventilation practices during general anesthesia for surgery 2. To assess the dependence of intra-operative and post-operative pulmonary complications on intra-operative Mechanical Ventilation (MV) settings

Detailed description

Research questions * What MV-settings are used during general anesthesia for surgery? * Do MV-settings vary in and/or between centers? * Do MV-settings vary internationally? * Are MV-settings associated with incidence of intra-operative pulmonary complications? * Are MV-settings associated with incidence of post-operative pulmonary complications?

Dorland G, Saadat W, van Meenen DMP, Neto AS, Hiesmayr M, Hollmann MW, Mills GH, Vidal Melo MF, Putensen C, Schmid W, Severgnini P, Wrigge H, de Abreu MG, Schultz MJ, Hemmes SNT, LAS VEGAS-investigators.

2025-05-142 citations

10.1016/j.jclinane.2025.111856

Associations of intraoperative end-tidal CO<sub>2</sub> levels with postoperative outcome-secondary analysis of a worldwide observational study.

Nasa P, van Meenen DMP, Paulus F, de Abreu MG, Bossers SM, Schober P, Schultz MJ, Neto AS, Hemmes SNT, LAS VEGAS-investigators, PROVE Network, ESAIC CTN, LAS VEGAS collaborators.

2024-12-197 citations

10.1016/j.jclinane.2024.111728

Sex dependence of postoperative pulmonary complications - A post hoc unmatched and matched analysis of LAS VEGAS.

Vermeulen TD, Hol L, Swart P, Hiesmayr M, Mills GH, Putensen C, Schmid W, Serpa Neto A, Severgnini P, Vidal Melo MF, Wrigge H, Hollmann MW, Gama de Abreu M, Schultz MJ, Hemmes SN, van Meenen DM, LAS VEGAS Collaborators group, PROVEnet, Clinical Trial Network of the European Society of Anaesthesiology.

2024-09-23

10.1016/j.jclinane.2024.111565

Risk factors for PPCs in laparoscopic non-robotic vs. laparoscopic robotic abdominal surgery (LapRas): rationale and protocol for a patient-level analysis of LAS VEGAS and AVATaR.

Serafini SC, Hemmes SNT, Serpa Neto A, Schultz MJ, Tschernko E, Gama de Abreu M, Mazzinari G, Ball L, LAS VEGAS – and the AVATaR – investigators.

2024-07-081 citations

10.1016/j.redare.2024.07.001

Factores de riesgo para PPC en cirugía abdominal laparoscópica no robótica frente a la laparoscópica robótica (LapRas): Razonamiento y protocolo mediante un análisis a nivel de paciente de LAS VEGAS y AVATaR

Simon Corrado Serafini, Sabrine N.T. Hemmes, Ary Serpa Neto, Marianne Schultz, Edda Tschernko et al. (8 authors)

Revista Española de Anestesiología y Reanimación2024-04-152 citations

10.1016/j.redar.2024.01.008

Geo-economic variations in epidemiology, ventilation management and outcome of patients receiving intraoperative ventilation during general anesthesia- posthoc analysis of an observational study in 29 countries.

Hol L, Nijbroek SGLH, Neto AS, Hemmes SNT, Hedenstierna G, Hiesmayr M, Hollmann MW, Mills GH, Vidal Melo MF, Putensen C, Schmid W, Severgnini P, Wrigge H, de Abreu MG, Pelosi P, Schultz MJ, LAS VEGAS study–investigators.

2022-01-07

10.1186/s12871-021-01560-x

The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients - a posthoc propensity score-weighted cohort analysis of the LAS VEGAS study.

Mazzinari G, Serpa Neto A, Hemmes SNT, Hedenstierna G, Jaber S, Hiesmayr M, Hollmann MW, Mills GH, Vidal Melo MF, Pearse RM, Putensen C, Schmid W, Severgnini P, Wrigge H, Cambronero OD, Ball L, de Abreu MG, Pelosi P, Schultz MJ, LAS VEGAS study–investigators, PROtective VEntilation NETwork, Clinical Trial Network of the European Society of Anaesthesiology.

2021-03-1920 citations

10.1186/s12871-021-01268-y

Sex difference and intra-operative tidal volume

Sunny G. L. H. Nijbroek, Liselotte Hol, Pien Swart, Sabrine N.T. Hemmes, Ary Serpa Neto et al. (19 authors)

European Journal of Anaesthesiology2021-02-1610 citations

10.1097/eja.0000000000001476

The effects of preoperative moderate to severe anaemia on length of hospital stay

Carolien S. E. Bulte, Christa Boer, Sabrine N.T. Hemmes, Ary Serpa Neto, Jan M. Binnekade et al. (19 authors)

European Journal of Anaesthesiology2021-01-0415 citations

10.1097/eja.0000000000001412

Intraoperative mechanical ventilation practice in thoracic surgery patients and its association with postoperative pulmonary complications: results of a multicenter prospective observational study.

Uhlig C, Neto AS, van der Woude M, Kiss T, Wittenstein J, Shelley B, Scholes H, Hiesmayr M, Vidal Melo MF, Sances D, Coskunfirat N, Pelosi P, Schultz M, Gama de Abreu M, LAS VEGAS# investigators, Protective Ventilation Network (PROVEnet), Clinical Trial Network of the European Society of Anaesthesiology.

2020-07-2230 citations

10.1186/s12871-020-01098-4

Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications.

Cortegiani A, Gregoretti C, Neto AS, Hemmes SNT, Ball L, Canet J, Hiesmayr M, Hollmann MW, Mills GH, Melo MFV, Putensen C, Schmid W, Severgnini P, Wrigge H, Gama de Abreu M, Schultz MJ, Pelosi P, LAS VEGAS Investigators, the PROVE Network, and the Clinical Trial Network of the European Society of Anaesthesiology.

2019-02-0853 citations

10.1016/j.bja.2018.10.063

The LAS VEGAS risk score for prediction of postoperative pulmonary complications

Ary Serpa Neto, Luiz Guilherme Villares da Costa, Sabrine N.T. Hemmes, Jaume Canet, Göran Hedenstierna et al. (18 authors)

European Journal of Anaesthesiology2018-06-19162 citations

10.1097/eja.0000000000000845

Intraoperative ventilation settings and their associations with postoperative pulmonary complications in obese patients.

Ball L, Hemmes SNT, Serpa Neto A, Bluth T, Canet J, Hiesmayr M, Hollmann MW, Mills GH, Vidal Melo MF, Putensen C, Schmid W, Severgnini P, Wrigge H, Gama de Abreu M, Schultz MJ, Pelosi P, LAS VEGAS investigators, PROVE Network, Clinical Trial Network of the European Society of Anaesthesiology.

2018-06-0269 citations

10.1016/j.bja.2018.04.021

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

The LAS VEGAS investigators

European Journal of Anaesthesiology2017-06-14317 citations

10.1097/eja.0000000000000646

Different strategies for mechanical VENTilation during CardioPulmonary Bypass (CPBVENT 2014): study protocol for a randomized controlled trial.

Bignami E, Guarnieri M, Saglietti F, Maglioni EM, Scolletta S, Romagnoli S, De Paulis S, Paternoster G, Trumello C, Meroni R, Scognamiglio A, Budillon AM, Pota V, Zangrillo A, Alfieri O.

2017-06-0716 citations

10.1186/s13063-017-2008-2

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Age ≥ 18 years * All surgical procedures requiring invasive mechanical ventilation (MV)during general anesthesia for laparoscopic or non-laparoscopic surgery. * This includes MV performed with supra-glottic devices (e.g. laryngeal mask) * This includes patients receiving MV at the onset of the procedure (e.g. Intensive Care Unit patients) * This includes patients who will receive one-lung ventilation during the procedure

Exclusion criteria

* Obstetric surgical procedures or any procedure during pregnancy * Surgical procedures outside the operating room * Surgical procedures involving extra-corporal circulation

Design outcomes

Primary

Measure	Time frame	Description
Post-operative pulmonary complications, possibly related to ventilation strategy	Post-operative on day of surgery, day 1, 2,3,4,5 and day 28	Effect of Mechanical Ventilation settings during general anesthesia for surgery on the incidence of post-operative pulmonary complications (new or prolonged invasive or non-invasive mechanical ventilation, need for oxygen therapy, respiratory failure, pneumonia, ARDS 'Acute Respiratory Distress Syndrome', pneumothorax) Defined post-operative pulmonary complications are recorded from the medical chart on day 0, 1, 2, 3, 4 and 5 after surgery. On day 28 length of hospital stay and in hospital death are assessed.

Secondary

Measure	Time frame	Description
Intra-operative complications related to the ventilation strategy	Time point(s) at which outcome measure is assessed is is: Day of surgery, day 1, 2, 3, 4, 5 and 28 after surgery	—
Mechanical ventilation-settings during general anesthesia for surgery	During the surgical procedure, from moment of to tracheal extubation or discharge from operation room (in case patient remains on mechanical ventilation)	* Variation of applied MV settings within centers * Variation of applied MV settings between centers on an international basis

Countries

Estonia, Germany, Italy, Lithuania, Netherlands, Norway, Slovenia, United States

Outcome results