Dataset Information

The effect of lung recruitment maneuvers on post-operative pulmonary complications for patients undergoing general anesthesia: A meta-analysis.

ABSTRACT:

Background

Respiratory function would be impaired during general anesthesia period. Researchers devoted their energies to finding effective strategies for protecting respiratory function. Low tidal volume, positive end-expiratory pressure (PEEP), and lung recruitment maneuvers (LRMs) were recommended for patients under mechanical ventilation. However, based on the current evidence, there was no consensus on whether LRMs should be routinely used for anesthetized patients with healthy lungs, and the benefits of them remained to be determined.

Materials and methods

To evaluate the benefits of LRMs on patients undergoing surgery with general anesthesia, we searched relevant studies in PubMed, EMBASE, Ovid Medline and the Cochrane Library up to June 30, 2018. The primary outcome was postoperative pulmonary complications (PPCs).

Results

Twelve trials involving 2756 anesthetized patients were included. The results of our study showed a significant benefit of LRMs for reducing the incidence of PPCs (RR = 0.67; 95%CI, 0.49 to 0.90; P<0.05; Chi2 = 32.94, p for heterogeneity = 0.0005, I2 = 67%). After subgroup analyses, we found LRMs combining with lung protective ventilation strategy and sustained recruitment maneuvers were associated with reducing the occurrence of PPCs. The results also revealed that the use of LRMs improved PaO2/FiO2 in non-obese patients, but with extremely high heterogeneity (I2 = 95%).

Conclusion

According to the findings from contemporary meta-analysis, LRMs combining with lung protective ventilation strategy may have an association with decreasing in the incidence of PPCs and improvement of oxygenation on non-obese patients. However, the conclusions must be interpreted cautiously as the outcome may be influenced dramatically due to varied LRMs and ventilation patterns.

SUBMITTER: Cui Y

PROVIDER: S-EPMC6541371 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

The effect of lung recruitment maneuvers on post-operative pulmonary complications for patients undergoing general anesthesia: A meta-analysis.

Cui Yu Y Cao Rong R Li Gen G Gong Tianqing T Ou Yingyu Y Huang Jing J

PloS one 20190529 5

<h4>Background</h4>Respiratory function would be impaired during general anesthesia period. Researchers devoted their energies to finding effective strategies for protecting respiratory function. Low tidal volume, positive end-expiratory pressure (PEEP), and lung recruitment maneuvers (LRMs) were recommended for patients under mechanical ventilation. However, based on the current evidence, there was no consensus on whether LRMs should be routinely used for anesthetized patients with healthy lung ...[more]

PMID: 31141541

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Project description:Elderly people and patients with colorectal cancer (CRC) are both at high risk of malnutrition. Therefore, it is of great significance to explore suitable malnutrition screening and diagnostic indicators for elderly patients with CRC. Recently, the Global Leadership Initiative on Malnutrition (GLIM) proposed new diagnostic criteria for malnutrition. The aim of this article was to evaluate the diagnostic value of GLIM criteria for malnutrition in elderly colorectal patients. We explored the relationship between GLIM-malnutrition, post-operative complications and the long-term prognosis of elderly colorectal patients. Elderly patients (aged ≥65 years) who underwent CRC surgery from January 2015 to December 2018 were included. Malnutrition was diagnosed based on the GLIM criteria. The relationships between GLIM-malnutrition and clinical characteristics were analyzed by t-tests, Mann-Whitney U tests, and chi-squared tests. The relationships between GLIM-malnutrition and post-operative complications were analyzed by chi-squared tests, and logistic regression analyses. The relationships between GLIM-malnutrition and the long-term prognosis were analyzed by Kaplan-Meier analyses and logistic and Cox regression analyses. A total of 385 elderly patients were included in this study, and 118 patients (30.65%) were diagnosed with malnutrition according to the GLIM criteria. GLIM-malnutrition was significantly associated with older age, lower body mass index (BMI), lower grip strength, tumor location, higher Nutrition Risk Screening 2002 (NRS-2002), and lower levels of albumin and hemoglobin. GLIM-malnutrition was an independent risk factor [odds ratio (OR): 1.753, 95% confidence interval (CI): 1.100-2.795, P=0.018] for post-operative complications. Cox regression analysis showed that GLIM-malnutrition was an independent risk factor for overall survival in elderly patients with CRC. The GLIM criteria are feasible diagnostic criteria for malnutrition of elderly patients with CRC. GLIM-malnutrition is significantly associated with post-operative complications and overall survival in elderly patients with CRC.

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Dataset Information

The effect of lung recruitment maneuvers on post-operative pulmonary complications for patients undergoing general anesthesia: A meta-analysis.

Background

Materials and methods

Results

Conclusion

Publications

The effect of lung recruitment maneuvers on post-operative pulmonary complications for patients undergoing general anesthesia: A meta-analysis.

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