Evidence map›Paper›PMID 34187530›Full record

Trial reportBMC anesthesiology2021

Intraoperative protective ventilation in patients undergoing major neurosurgical interventions: a randomized clinical trial.

Federico Longhini, Laura Pasin, Claudia Montagnini, Petra Konrad, Andrea Bruni, Eugenio Garofalo, Paolo Murabito, Corrado Pelaia, Valentina Rondi, Fabrizio Dellapiazza and 4 more

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 3 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 3 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 2 countries.

Federico LonghiniAnesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Laura PasinAnesthesia and Intensive Care, University Hospital of Padua, Via Giustiniani 2, Padova, Italy. laurapasin1704@gmail.com.
Claudia MontagniniAnesthesia and Intensive Care, "Maggiore Della Carità" Hospital, Novara, Italy.
Petra KonradAnesthesia and Intensive Care, "Maggiore Della Carità" Hospital, Novara, Italy.
Andrea BruniAnesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Eugenio GarofaloAnesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Paolo MurabitoDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Corrado PelaiaAnesthesia and Intensive Care, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
Valentina RondiAnesthesia and Intensive Care, "Maggiore Della Carità" Hospital, Novara, Italy.
Fabrizio DellapiazzaAnesthesia and Intensive Care, Sant'Andrea Hospital, ASL VC, Vercelli, Italy.
Gianmaria CammarotaAnesthesia and Intensive Care, "Maggiore Della Carità" Hospital, Novara, Italy.
Rosanna VaschettoAnesthesia and Intensive Care, "Maggiore Della Carità" Hospital, Novara, Italy.
Marcus J SchultzDepartment of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.
Paolo NavalesiAnesthesia and Intensive Care, University Hospital of Padua, Via Giustiniani 2, Padova, Italy.
Magna Graecia University · ITUniversity of Padua · ITAcademic Medical Center · NLCTO Andrea Alesini · ITUniversity of Catania · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPost-operative pulmonary complications (PPC) can develop in up to 13% of patients undergoing neurosurgical procedures and may adversely affect clinical outcome. The use of intraoperative lung protective ventilation (LPV) strategies, usually including the use of a low V

methodsThis single-centre, pilot randomized clinical trial was conducted at the University Hospital "Maggiore della Carità" (Novara, Italy). Adult patients undergoing major cerebral or spinal neurosurgical interventions with risk index for pulmonary post-operative complications > 2 and not expected to need post-operative intensive care unit (ICU) admission were considered eligible. Patients were randomly assigned to either LPV (Vt = 6 ml/kg of ideal body weight (IBW), respiratory rate initially set at 16 breaths/min, PEEP at 5 cmH2O and application of a recruitment manoeuvre (RM) immediately after intubation and at every disconnection from the ventilator) or control treatment (Vt = 10 ml/kg of IBW, respiratory rate initially set at 6-8 breaths/min, no PEEP and no RM). Primary outcomes of the study were intraoperative adverse events, the level of cerebral tension at dura opening and the intraoperative control of PaCO

resultsA total of 60 patients, 30 for each group, were randomized. During brain surgery, the number of episodes of intraoperative hypercapnia and grade of cerebral tension were similar between patients randomized to receive control or LPV strategies. No difference in the rate of intraoperative adverse events was found between groups. The rate of postoperative pulmonary and extrapulmonary complications and major clinical outcomes were similar between groups.

conclusionsLPV strategies in patients undergoing major neurosurgical intervention are feasible. Larger clinical trials are needed to assess their role in postoperative clinical outcome improvements.

trial registrationregistered on the Australian New Zealand Clinical Trial Registry ( www.anzctr.org.au ), registration number ACTRN12615000707561.

Indexed as

AdultAgedFemaleHospitalizationHospitals, UniversityHumansIntensive Care UnitsIntraoperative CareItalyLength of StayLung DiseasesMaleMiddle AgedNeurosurgical ProceduresPilot ProjectsPositive-Pressure RespirationMechanical ventilationNeurosurgeryPostoperative pulmonary complications

Identifiers

PMID34187530
PMCPMC8241565
OpenAlexW3175329393

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.