Observational studyAnesthesiology2021
A Lower Tidal Volume Regimen during One-lung Ventilation for Lung Resection Surgery Is Not Associated with Reduced Postoperative Pulmonary Complications.
Observational study in Anesthesiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05922449 (Using Thoracic Paravertebral Block for Perioperative Lung Preservation During VATS Pulmonary Surgery), which is not on this map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Using Thoracic Paravertebral Block for Perioperative Lung Preservation During VATS Pulmonary Surgery: A Dual Center Randomized Controlled Trial
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Prediction models for postoperative pulmonary complications: a systematic review and meta-analysis.British journal of anaesthesia · 2025Pooled it
- Does tidal volume challenge improve the feasibility of pulse pressure variation in patients mechanically ventilated at low tidal volumes? A systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Mechanical power during one-lung ventilation is associated with postoperative pulmonary complications in patients undergoing lobectomy: a single-center prospective cohort study.BMC anesthesiology · 2026Trial
- An optimal protective ventilation strategy in lung resection surgery: a prospective, single-center, three-arm randomized controlled trial.Updates in surgery · 2025Trial
- Protecting the non-operative lobe/s of the operative lung can reduce the pneumonia incidence after thoracoscopic lobectomy: a randomised controlled trial.Scientific reports · 2024Trial
- Intraoperative Hemodynamic Management During Esophagectomy and Implications for Postoperative Care.Journal of the American College of Surgeons · 2026Article
- Intraoperative Ventilatory Strategies in Patients Undergoing Video-Assisted Thoracic Surgery: A Narrative Review.Advances in therapy · 2025Review
- Comparison of low vs high tidal volumes in one-lung ventilation during thoracic surgery: a propensity-weighted cohort study.Scientific reports · 2025Observational
- Clinical practice of one-lung ventilation in mainland China: a nationwide questionnaire survey.BMC anesthesiology · 2025Article
- Effect of Thoracic Paravertebral Block on Postoperative Pulmonary Complications After Video-Assisted Thoracoscopic Surgery: A Dual-Center Randomized Clinical Trial.Therapeutics and clinical risk management · 2025Article
- Review
- Multicenter Analysis of the Relationship Between Operative Team Familiarity and Safety and Efficiency Outcomes in Cardiac Surgery.Circulation. Cardiovascular quality and outcomes · 2024Article
- Association between inspired oxygen fraction and development of postoperative pulmonary complications in thoracic surgery: a multicentre retrospective cohort study.British journal of anaesthesia · 2024Observational
- Impaired oxygenation after lung resection: Incidence and perioperative risk factors.Journal of clinical anesthesia · 2024Article
- PEEP on postoperative complications: not to fast.Journal of anesthesia · 2024Article
- Association between mechanical power during one-lung ventilation and pulmonary complications after thoracoscopic lung resection surgery: a prospective observational study.BMC anesthesiology · 2024Observational
- Effects of Intra-operative Cardiopulmonary Variability On Post-operative Pulmonary Complications in Major Non-cardiac Surgery: A Retrospective Cohort Study.Journal of medical systems · 2024Article
- Article
- Article
- Smoking cessation in Chinese patients undergoing thoracic surgery: A multicenter prospective observational study.Tobacco induced diseases · 2024Article
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Authors and funding
18 authors at 1 institution in 1 country.
Funding
Abstract
backgroundProtective ventilation may improve outcomes after major surgery. However, in the context of one-lung ventilation, such a strategy is incompletely defined. The authors hypothesized that a putative one-lung protective ventilation regimen would be independently associated with decreased odds of pulmonary complications after thoracic surgery.
methodsThe authors merged Society of Thoracic Surgeons Database and Multicenter Perioperative Outcomes Group intraoperative data for lung resection procedures using one-lung ventilation across five institutions from 2012 to 2016. They defined one-lung protective ventilation as the combination of both median tidal volume 5 ml/kg or lower predicted body weight and positive end-expiratory pressure 5 cm H2O or greater. The primary outcome was a composite of 30-day major postoperative pulmonary complications.
resultsA total of 3,232 cases were available for analysis. Tidal volumes decreased modestly during the study period (6.7 to 6.0 ml/kg; P < 0.001), and positive end-expiratory pressure increased from 4 to 5 cm H2O (P < 0.001). Despite increasing adoption of a "protective ventilation" strategy (5.7% in 2012 vs. 17.9% in 2016), the prevalence of pulmonary complications did not change significantly (11.4 to 15.7%; P = 0.147). In a propensity score matched cohort (381 matched pairs), protective ventilation (mean tidal volume 6.4 vs. 4.4 ml/kg) was not associated with a reduction in pulmonary complications (adjusted odds ratio, 0.86; 95% CI, 0.56 to 1.32). In an unmatched cohort, the authors were unable to define a specific alternative combination of positive end-expiratory pressure and tidal volume that was associated with decreased risk of pulmonary complications.
conclusionsIn this multicenter retrospective observational analysis of patients undergoing one-lung ventilation during thoracic surgery, the authors did not detect an independent association between a low tidal volume lung-protective ventilation regimen and a composite of postoperative pulmonary complications. EDITOR’S PERSPECTIVE:
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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.