Evidence map›Paper›PMID 38509825›Full record

Trial reportAnnals of geriatric medicine and research2024

Effects of Different Extubation Strategies on Atelectasis in Older Adults after Major Abdominal Surgery: A Prospective Randomized Controlled Trial.

Rahul Madhukar Kashyap, Pradeep Bhatia, Tanvi M Meshram, Swati Chhabra, Rakesh Kumar

Open access · diamondAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Annals of geriatric medicine and research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact, top 94% 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

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 0 citations in OpenAlex.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Rahul Madhukar KashyapDepartment of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.
Pradeep BhatiaDepartment of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.
Tanvi M MeshramDepartment of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.
Swati ChhabraDepartment of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.
Rakesh KumarDepartment of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, India.
All India Institute of Medical Sciences Jodhpur · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder patients are particularly vulnerable to age-related respiratory changes. This prospective randomized controlled trial studied the effects of high and low fractions of inspired oxygen (FiO2) with the recruitment maneuver (RM) during extubation on lung atelectasis postoperatively in older patients undergoing major abdominal surgery.

methodsWe randomized a total of 126 patients aged >60 years who underwent both elective and emergency major abdominal surgeries and met the inclusion criteria into three groups (H, HR, and LR) using computer-generated block randomization. Group H received high FiO2 (1), Group HR received high FiO2 (1) with RM followed by a positive end-expiratory pressure of 5 cm H2O, and Group LR received low FiO2 (0.4) with RM followed by a positive end-expiratory pressure of 5 cm H2O 10 minutes before extubation. Oxygenation and atelectasis were measured using the arterial partial pressure of oxygen (PaO2)/FiO2 ratios and lung ultrasound score. Postoperative pulmonary complications were recorded up to 24 hours postoperatively.

resultsThe mean PaO2/FiO2 at 30 minutes post-extubation was significantly higher in Groups LR and HR compared to that in Group H (390.71±29.55, 381.97±24.97, and 355.37±31.70; p<0.001). In the immediate postoperative period, the median lung ultrasound score was higher in Group H than that in Groups LR and HR (6 [5-7], 3 [3-5], and 3.5 [2.25-4.75]; p<0.001). The incidence of oxygen desaturation and oxygen requirements was higher in Group H during the postoperative period.

conclusionThe RM before extubation is beneficial in reducing atelectasis and postoperative pulmonary complications, irrespective of the FiO2 concentration used in older adults undergoing major abdominal surgeries. (Trail registration number: Reference No. CTRI/2022/04/042115; date of CTRI registration 25/02/2022; and date of enrolment of the first research participant 05/05/2022).

Indexed as

AbdomenAirway ExtubationPositive-Pressure RespirationPostoperative ComplicationsPulmonary AtelectasisAgedAged, 80 and overFemaleHumansMaleMiddle AgedOxygenProspective StudiesOxygenAirway extubationAtelectasisElderlyFrail older adultsSurgery

Identifiers

PMID38509825
PMCPMC11217653
OpenAlexW4393054751

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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.