Relationship between intraoperative mechanical power and postoperative pulmonary complications in patients undergoing long-duration neurosurgery
10.3760/cma.j.cn131073-20241231-01007
- VernacularTitle:长时间神经外科手术患者术中机械功率与术后肺部并发症的关系
- Author:
Lianhao JIANG
1
;
Yifei WANG
;
Lingling LIU
;
Yuanyuan KANG
;
Jun CHEN
;
Hongtao ZHANG
Author Information
1. 天津市环湖医院麻醉科 天津市脑血流重建与头颈肿瘤新技术转化重点实验室，天津 300350
- Publication Type:Journal Article
- Keywords:
Respiration, artificial;
Postoperative complications;
Neurosurgical procedures;
Mechanical power
- From:
Chinese Journal of Anesthesiology
2025;45(10):1264-1268
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the relationship between intraoperative mechanical power and postoperative pulmonary complications in patients undergoing long-duration neurosurgery.Methods:This was a case-control study. Based on the duration of mechanical ventilation>8 h, the clinical data(baseline characteristics, intraoperative information and hospitalization) of patients underwent first elective craniotomy under general anesthesia at Tianjin Huanhu Hospital from January 1, 2019 to December 31, 2021 were retrospectively collected. The patients were divided into pulmonary complication group (group P) and non-pulmonary complication group (group N) based on the occurrence of postoperative pulmonary complications. Ventilation-related risk factors for postoperative pulmonary complications were identified by the multivariate logistic regression analysis, and the accuracy of intraoperative tidal volume, peak airway pressure, respiratory rate and mechanical power in predicting postoperative pulmonary complications was assessed using the receiver operating characteristic curve.Results:A total of 555 patients were finally included, with 247 patients in group P and 308 patients in group N. The duration of mechanical ventilation, tidal volume, peak airway pressure, respiratory rate, mechanical power, length of hospitalization and mortality during hospitalization were significantly higher in group P than in group N ( P<0.05). The results of multivariate logistic regression analysis showed that intraoperative peak airway pressure, respiratory rate and mechanical power were risk factors for postoperative pulmonary complications ( P<0.05). The area under the receiver operating characteristic curve (95% confidence interval) of intraoperative peak airway pressure, respiratory rate and mechanical power in predicting postoperative pulmonary complications was 0.726(0.572-0.666), 0.619(0.684-0.768) and 0.958(0.942-0.974)respectively. Conclusions:Intraoperative mechanical power is an independent risk factor for postoperative pulmonary complications and an important ventilation parameter for predicting postoperative pulmonary complications in patients undergoing long-duration neurosurgery.
