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Rationale and Study Design for an Individualized Perioperative Open Lung Ventilatory Strategy in Patients on One-Lung Ventilation (iPROVE-OLV)
Hosp Clin Barcelona, Dept Anesthesia & Crit Care, Villarroel 170, Barcelona 08036, Spain.
Hosp Clin Barcelona, Dept Anesthesia & Crit Care, Villarroel 170, Barcelona 08036, Spain;Inst Salud Carlos III, CIBER Enfermedades Resp, Madrid, Spain.ORCID iD: 0000-0002-1907-5323
Hosp Santa Creu & Sant Pau, Dept Anesthesia & Crit Care, Barcelona, Spain.
Hosp Clin Barcelona, Dept Anesthesia & Crit Care, Villarroel 170, Barcelona 08036, Spain.
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2019 (English)In: Journal of Cardiothoracic and Vascular Anesthesia, ISSN 1053-0770, E-ISSN 1532-8422, Vol. 33, no 9, p. 2492-2502Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this clinical trial is to examine whether it is possible to reduce postoperative complications using an individualized perioperative ventilatory strategy versus using a standard lung-protective ventilation strategy in patients scheduled for thoracic surgery requiring one-lung ventilation. Design: International, multicenter, prospective, randomized controlled clinical trial. Setting: A network of university hospitals. Participants: The study comprises 1,380 patients scheduled for thoracic surgery. Interventions: The individualized group will receive intraoperative recruitment maneuvers followed by individualized positive end-expiratory pressure (open lung approach) during the intraoperative period plus postoperative ventilatory support with high-flow nasal cannula, whereas the control group will be managed with conventional lung-protective ventilation. Measurements and Main Results: Individual and total number of postoperative complications, including atelectasis, pneumothorax, pleural effusion, pneumonia, acute lung injury; unplanned readmission and reintubation; length of stay and death in the critical care unit and in the hospital will be analyzed for both groups. The authors hypothesize that the intraoperative application of an open lung approach followed by an individual indication of high-flow nasal cannula in the postoperative period will reduce pulmonary complications and length of hospital stay in high-risk surgical patients. (C) 2019 Published by Elsevier Inc.

Place, publisher, year, edition, pages
W B SAUNDERS CO-ELSEVIER INC , 2019. Vol. 33, no 9, p. 2492-2502
Keywords [en]
mechanical ventilation, postoperative pulmonary complications, one-lung ventilation, positive end-expiratory pressure, recruitment maneuvers
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:uu:diva-394056DOI: 10.1053/j.jvca.2019.01.056ISI: 000483007700024PubMedID: 30928294OAI: oai:DiVA.org:uu-394056DiVA, id: diva2:1357284
Available from: 2019-10-03 Created: 2019-10-03 Last updated: 2019-10-03Bibliographically approved

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