Postoperative Pulmonary Complications in the ENIGMA II Trial: APost HocAnalysis

医学 事后 析因分析 麻醉 内科学
作者
Philip J. Peyton,Grace Liskaser,Alexander Ho,Harry Marsh,C. Etherington,Frederick Torlot,Manisha Desai,George Perrett,Brian J. S. Chee,Kate Leslie,Paul S. Myles
出处
期刊:Anesthesiology [Ovid Technologies (Wolters Kluwer)]
卷期号:138 (4): 354-363 被引量:5
标识
DOI:10.1097/aln.0000000000004497
摘要

Background Nitrous oxide promotes absorption atelectasis in poorly ventilated lung segments at high inspired concentrations. The Evaluation of Nitrous oxide In the Gas Mixture for Anesthesia (ENIGMA) trial found a higher incidence of postoperative pulmonary complications and wound sepsis with nitrous oxide anesthesia in major surgery compared to a fraction of inspired oxygen of 0.8 without nitrous oxide. The larger ENIGMA II trial randomized patients to nitrous oxide or air at a fraction of inspired oxygen of 0.3 but found no effect on wound infection or sepsis. However, postoperative pulmonary complications were not measured. In the current study, post hoc data were collected to determine whether atelectasis and pneumonia incidences were higher with nitrous oxide in patients who were recruited to the Australian cohort of ENIGMA II. Methods Digital health records of patients who participated in the trial at 10 Australian hospitals were examined blinded to trial treatment allocation. The primary endpoint was the incidence of atelectasis, defined as lung atelectasis or collapse reported on chest radiology. Pneumonia, as a secondary endpoint, required a diagnostic chest radiology report with fever, leukocytosis, or positive sputum culture. Comparison of the nitrous oxide and nitrous oxide–free groups was done according to intention to treat using chi-square tests. Results Data from 2,328 randomized patients were included in the final data set. The two treatment groups were similar in surgical type and duration, risk factors, and perioperative management recorded for ENIGMA II. There was a 19.3% lower incidence of atelectasis with nitrous oxide (171 of 1,169 [14.6%] vs. 210 of 1,159 [18.1%]; odds ratio, 0.77; 95% CI, 0.62 to 0.97; P = 0.023). There was no difference in pneumonia incidence (60 of 1,169 [5.1%] vs. 52 of 1159 [4.5%]; odds ratio, 1.15; 95% CI, 0.77 to 1.72; P = 0.467) or combined pulmonary complications (odds ratio, 0.84; 95% CI, 0.69 to 1.03; P = 0.093). Conclusions In contrast to the earlier ENIGMA trial, nitrous oxide anesthesia in the ENIGMA II trial was associated with a lower incidence of lung atelectasis, but not pneumonia, after major surgery. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
zhh发布了新的文献求助10
1秒前
1秒前
汉堡包应助七.采纳,获得10
1秒前
1秒前
Elian完成签到,获得积分10
1秒前
1秒前
l9完成签到 ,获得积分10
1秒前
我爱科研完成签到,获得积分10
2秒前
2秒前
优雅的半凡完成签到,获得积分10
2秒前
KING完成签到,获得积分10
3秒前
曾经如是完成签到 ,获得积分10
3秒前
4秒前
4秒前
王算法发布了新的文献求助10
4秒前
spark完成签到 ,获得积分10
4秒前
翁雁丝发布了新的文献求助10
4秒前
4秒前
Sg发布了新的文献求助30
5秒前
田様应助张张采纳,获得10
5秒前
想读博完成签到,获得积分10
5秒前
草拟大坝完成签到 ,获得积分0
5秒前
6秒前
6秒前
南风发布了新的文献求助10
7秒前
8秒前
wyx完成签到,获得积分10
8秒前
8秒前
8秒前
风中冰蝶发布了新的文献求助10
9秒前
轻松的蜜蜂完成签到,获得积分10
9秒前
9秒前
Zhao完成签到,获得积分10
9秒前
冷静的尔冬完成签到 ,获得积分10
11秒前
shiqiyu发布了新的文献求助10
11秒前
搜集达人应助tan采纳,获得10
11秒前
12秒前
12秒前
13秒前
13秒前
高分求助中
Evolution 10000
Becoming: An Introduction to Jung's Concept of Individuation 600
Distribution Dependent Stochastic Differential Equations 500
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
A new species of Velataspis (Hemiptera Coccoidea Diaspididae) from tea in Assam 500
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 500
The Kinetic Nitration and Basicity of 1,2,4-Triazol-5-ones 440
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3159180
求助须知:如何正确求助?哪些是违规求助? 2810321
关于积分的说明 7887314
捐赠科研通 2469183
什么是DOI,文献DOI怎么找? 1314687
科研通“疑难数据库(出版商)”最低求助积分说明 630682
版权声明 602012