ArticleCritical care medicine2017
Dose-Dependent Protective Effect of Inhalational Anesthetics Against Postoperative Respiratory Complications: A Prospective Analysis of Data on File From Three Hospitals in New England.
Article in Critical care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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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.
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Who cites it
17 citing papers in PubMed, 53 citations in OpenAlex.
- Comparison of the safety and efficacy of desflurane versus sevoflurane on postoperative cognitive function and early recovery quality in elderly orthopedic patients: a prospective, randomized controlled trial.Frontiers in medicine · 2025Trial
- Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial.BMJ (Clinical research ed.) · 2018Trial
- Postoperative pulmonary complications of desflurane- versus sevoflurane-based general anesthesia in patients with chronic obstructive pulmonary disease or asthma undergoing gastrointestinal cancer surgery: a nationwide retrospective cohort study.Journal of anesthesia · 2026Article
- Effects of volatile anesthetics on peripheral nerve regeneration in a sciatic cut repair murine model.Frontiers in cellular neuroscience · 2026Article
- Inhaled Anesthetics: Environmental Role, Occupational Risk, and Clinical Use.Journal of clinical medicine · 2021Review
- Effects of laparoscopic vs open abdominal surgery on costs and hospital readmission rate and its effect modification by surgeons' case volume.Surgical endoscopy · 2020Article
- Ventilatory frequency during intraoperative mechanical ventilation and postoperative pulmonary complications: a hospital registry study.British journal of anaesthesia · 2020Article
- Protective ventilation from ICU to operating room: state of art and new horizons.Korean journal of anesthesiology · 2020Review
- Article
- The Use of Volatile Anesthetics as Sedatives for Acute Respiratory Distress Syndrome.Translational perioperative and pain medicine · 2019Article
- Recent advances in understanding and managing postoperative respiratory problems.F1000Research · 2019Review
- High intraoperative inspiratory oxygen fraction and risk of major respiratory complications.British journal of anaesthesia · 2017Article
- Prevention of respiratory complications of the surgical patient: actionable plan for continued process improvement.Current opinion in anaesthesiology · 2017Review
- Proper selection of sedative drugs improves outcomes: volatile anesthetics are surgeons' best friends.Annals of translational medicine · 2017Article
- Migraine and risk of perioperative ischemic stroke and hospital readmission: hospital based registry study.BMJ (Clinical research ed.) · 2017Article
- Volatile anesthetics for lung protection: a bridge between operating rooms and intensive care units?Annals of translational medicine · 2016Article
- The hypoxic pulmonary vasoconstriction: From physiology to clinical application in thoracic surgery.Saudi journal of anaesthesiaReview
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesInhalational anesthetics are bronchodilators with immunomodulatory effects. We sought to determine the effect of inhalational anesthetic dose on risk of severe postoperative respiratory complications.
designProspective analysis of data on file in surgical cases between January 2007 and December 2015.
settingMassachusetts General Hospital (tertiary referral center) and two affiliated community hospitals. PATIENTS: A total of 124,497 adult patients (105,267 in the study cohort and 19,230 in the validation cohort) undergoing noncardiac surgical procedures and requiring general anesthesia with endotracheal intubation.
interventionsMedian effective dose equivalent of inhalational anesthetics during surgery (derived from mean end-tidal inhalational anesthetic concentrations). MEASUREMENTS AND MAIN
resultsPostoperative respiratory complications occurred in 6,979 of 124,497 cases (5.61%). High inhalational anesthetic dose of 1.20 (1.13-1.30) (median [interquartile range])-fold median effective dose equivalent versus 0.57 (0.45-0.64)-fold median effective dose equivalent was associated with lower odds of postoperative respiratory complications (odds ratio, 0.59; 95% CI, 0.53-0.65; p < 0.001). Additionally, high inhalational anesthetic dose was associated with lower 30-day mortality and lower cost. Inhalational anesthetic dose increase and reduced risk of postoperative respiratory complications remained significant in sensitivity analyses stratified by preoperative and intraoperative risk factors.
conclusionsIntraoperative use of higher inhalational anesthetic doses is strongly associated with lower odds of postoperative respiratory complications, lower 30-day mortality, and lower cost of hospital care. The authors speculate based on these data that sedation with inhalational anesthetics outside of the operating room may likewise have protective effects that decrease the risk of respiratory complications in vulnerable patients.
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