The association of intraoperative positive end-expiratory pressure with pulmonary complications after thoracoscopic lung surgery: A propensity score-matching study
- VernacularTitle:术中呼气末正压对胸腔镜肺部手术后肺部并发症影响的倾向性评分匹配研究
- Author:
Gongwei ZHANG
1
,
2
;
Hongmei LIU
3
;
Hongwei ZHANG
4
;
Hai YU
5
Author Information
1. 1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China 2. Department of Anesthesiology, The First People'
2. s Hospital of Shuangliu District, West China (Airport) Hospital, Sichuan University, Chengdu, 610200, P. R. China
3. Department of Anesthesiology, West China Fourth Hospital, Sichuan University, Chengdu, 610044, P. R. China
4. Department of Anesthesiology, Tumor Hospital of Sichuan Province, Chengdu, 610041, P. R. China
5. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Positive end-expiratory pressure;
one-lung ventilation;
video-assisted thoracoscopic surgery;
pneumonectomy;
postoperative pulmonary complications;
propensity score-matching analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(05):702-709
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the correlation between positive end-expiratory pressure (PEEP) level and postoperative pulmonary complications (PPCs) in patients undergoing thoracoscopic lung surgery. Methods The clinical data of patients who underwent elective thoracoscopic lung surgery at West China Hospital of Sichuan University from January 2022 to June 2023 were retrospectively analyzed. Patients were divided into 2 groups according to intraoperative PEEP levels: a PEEP 5 cm H2O group and a PEEP 10 cm H2O group. The incidence of PPCs in the two groups after matching was compared using a nearest neighbor matching method with a ratio of 1∶1, setting the clamp value as 0.02. Results A total of 538 patients were screened, and after propensity score-matching, a total of 229 pairs (458 patients) were matched, with an average age of 53.9 years and 69.4% (318/458) females. A total of 118 (25.8%) patients had PPCs during hospitalization after surgery, including 60 (26.2%) patients in the PEEP 5 cm H2O group and 58 (25.3%) patients in the PEEP 10 cm H2O group, with no statistically significant difference between the two groups [OR=0.997, 95%CI (0.495, 1.926), P=0.915]. Multivariate logistic regression analysis showed that PEEP was not an independent risk factor for PPCs [OR=0.920, 95%CI (0.587, 1.441), P=0.715]. Conclusion For patients undergoing thoracoscopic lung surgery, intraoperative PEEP (5 cm H2O or 10 cm H2O) is not associated with the risk of PPCs during hospitalization after surgery, which needs to be further verified by prospective, large-sample randomized controlled studies.
