Evidence map›Paper›PMID 28493943›Full record

Trial reportPloS one2017

Open lung approach versus standard protective strategies: Effects on driving pressure and ventilatory efficiency during anesthesia - A pilot, randomized controlled trial.

Carlos Ferrando, Fernando Suarez-Sipmann, Gerardo Tusman, Irene León, Esther Romero, Estefania Gracia, Ana Mugarra, Blanca Arocas, Natividad Pozo, Marina Soro and 1 more

3 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 21 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 6 pooled it
6.5field-weighted citation impact, top 3% 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.

NCT02798133 nacompletednot on this map

Open Lung Approach Versus Standard Protective Strategies: Effects on Driving Pressure and Ventilatory Efficiency During Anesthesia

TypeinterventionalSponsorFundación para la Investigación del Hospital Clínico de ValenciaRan2014 to 2014Enrolled36ConditionsLung CollapseArmsOLA, RM-5
NCT05511610 nacompletednot on this mapstarted 2024, after this paper: background citation

Accuracy of the MAAS Method (Minimal-flow Auto-control Anesthesia System) for the Administration of Desflurane and Sevoflurane in the Anesthetic Maintenance Phase. Prospective and Paired Observational Study.

TypeinterventionalSponsorFundación Pública Andaluza para la gestión de la Investigación en SevillaRan2024 to 2025Enrolled28ConditionsAnesthesia, Sevoflurane, Desflurane, Low Flow AnesthesiaArmsSevoflurane uptake and supply, Washout phase, Desflurane uptake and supply, Final phase
NCT05514366 nacompletednot on this mapstarted 2023, after this paper: background citation

Influence of Inspiratory Pause on Ventilatory Efficiency and Tidal Volume Distribution in Patients Undergoing Robotic Prostate Surgery and Ventilated With an Individualized Open Lung Approach. A Prospective Paired Study.

TypeinterventionalSponsorFundación Pública Andaluza para la gestión de la Investigación en SevillaRan2023 to 2023Enrolled18ConditionsMechanical Ventilation, Positive End-Expiratory Pressure, AnesthesiaArmsModifying EIP under a tOLA before pneumoperitoneum, Modifying EIP under a tOLA with pneumoperitoneum, Atelectasis test
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 6 syntheses or guidelines pooled it, 66 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Article
  15. Article
  16. Review
  17. Article
  18. Driving pressure guided ventilation.Korean journal of anesthesiology · 2020
    Review
  19. Review
  20. Perioperative lung protective ventilation.BMJ (Clinical research ed.) · 2018
    Review
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

11 authors at 4 institutions in 3 countries.

Carlos FerrandoDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Fernando Suarez-SipmannCIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
Gerardo TusmanDepartment of Anesthesiology, Hospital Privado de Comunidad, Mar de Plata, Argentina.
Irene LeónDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Esther RomeroDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Estefania GraciaDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Ana MugarraDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Blanca ArocasDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Natividad PozoINCLIVA Clinical Research Institute, Hospital Clínico Universitario, Valencia, Spain.
Marina SoroDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Francisco J BeldaDepartment of Anesthesiology and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
Hospital Clínico Universitario de Valencia · ESHospital Privado de Comunidad · ARINCLIVA Health Research Institute · ESUppsala University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia.

methodsConsecutive patients scheduled for major abdominal surgery were submitted to low-VT ventilation (6 ml·kg-1) and standard PEEP of 5 cmH2O (pre-RM, n = 36). After 30 min estabilization all patients received a RM and were randomly allocated to either continue with the same PEEP (RM-5 group, n = 18) or to an individualized open-lung PEEP (OL-PEEP) (Open Lung Approach, OLA group, n = 18) defined as the level resulting in maximal Cdyn during a decremental PEEP trial. We compared the effects on driving pressure and lung efficiency measured by volumetric capnography.

resultsOL-PEEP was found at 8±2 cmH2O. 36 patients were included in the final analysis. When compared with pre-RM, OLA resulted in a 22% increase in compliance and a 28% decrease in driving pressure when compared to pre-RM. These parameters did not improve in the RM-5. The trend of the DP was significantly different between the OLA and RM-5 groups (p = 0.002). VDalv/VTalv was significantly lower in the OLA group after the RM (p = 0.035).

conclusionsLung recruitment applied during low-VT ventilation improves driving pressure and lung efficiency only when applied as an open-lung strategy with an individualized PEEP in patients without lung diseases undergoing major abdominal surgery.

trial registrationClinicalTrials.gov NCT02798133.

Indexed as

Positive-Pressure RespirationAgedAnesthesiologyCapnographyFemaleHumansLungMaleMiddle AgedTidal Volume

Identifiers

PMID28493943
PMCPMC5426745
OpenAlexW2612373150

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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 OpenQuestion graph.