Clinical practice of intraoperative ventilation management in cardiac surgery: A nationwide survey in China
- VernacularTitle:成人体外循环心脏手术中通气管理临床实践的全国性调查研究
- Author:
Jiaxin HE
1
;
Hong YU
1
;
Xuefei LI
1
;
Hai YU
1
Author Information
1. Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Questionnaire survey;
lung-protective ventilation;
cardiopulmonary bypass;
cardiac surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2024;31(08):1174-1180
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the current status of routine practice and perspective of anesthesiologists regarding ventilation strategies during cardiac surgery, and to analyze whether there is a gap between the clinical application and theoretical understanding of lung-protective ventilation (LPV) strategies. Methods We conducted a multi-institutional cross-sectional survey of anesthesiologists working at high-volume (>1000 cardiac procedures each year) Chinese hospitals. The electronic questionnaire was designed and distributed from September 2021 to February 2022. Results A total of 323 replies were collected and 297 (92.0%) replies were valid. Among the respondents, 84.8% (252/297) performed the combination of low tidal volume (VT), positive end-expiratory pressure (PEEP) and alveolar recruitment maneuver (ARM) during non-CPB period. The vast majority of respondents (90.6%, 269/297) ventilated patients with the VT of 6-8 mL/kg. 92.3% (274/297) of respondents applied PEEP, among those 57.9% (172/297) set a PEEP level <5 cm H2O. Most of the respondents (67.3%, 200/297) performed intraoperative ARM, and manual ARM was used by 86.2% (256/297) of anesthesiologists. During CPB, 89.9% (267/297) of respondents withdrew mechanical ventilation, and 29.6% (88/297) performed ARM. Conclusion This national survey in China showed that the majority of anesthesiologists adopted LPV strategy with the combination of low VT, PEEP and ARM during cardiac surgery. Except VT, the intraoperative ventilator settings varied widely from one anesthesiologist to another. Meanwhile, there is a gap between the clinical practice and theoretical understanding of LPV.
