Evidence map›Paper›PMID 40020692›Full record

Trial reportThe Lancet. Respiratory medicine2025

Perioperative lung expansion and pulmonary outcomes after open abdominal surgery versus usual care in the USA (PRIME-AIR): a multicentre, randomised, controlled, phase 3 trial.

Ana Fernandez-Bustamante, Robert A Parker, Gyorgy Frendl, Jae Woo Lee, Alexander Nagrebetsky, Loreta Grecu, David Amar, Pedro Tanaka, Juraj Sprung, Ravindra A Gupta and 16 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled TrialClinical Trial, Phase III
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Lancet. Respiratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07728214 (Reminder-enhanced Incentive Spirometry Evaluation), which is not on this map. Cited by 14 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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.

NCT07728214 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Reminder-enhanced Incentive Spirometry Evaluation (RISE)

TypeinterventionalSponsorUniversity of Colorado, DenverRan2026 to 2029Enrolled88ConditionsHypoxemiaArmsAlarms ON
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
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  6. Review
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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

26 authors.

Ana Fernandez-BustamanteDepartment of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.
Robert A ParkerBiostatistics Center, Massachusetts General Hospital, Department of Medicine, Harvard Medical School, Boston, MA, USA.
Gyorgy FrendlDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Jae Woo LeeDepartment of Anesthesiology, University of California San Francisco, San Francisco, CA, USA.
Alexander NagrebetskyDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Loreta GrecuDepartment of Anesthesiology, Duke University, Durham, NC, USA.
David AmarDepartment of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Pedro TanakaDepartment of Anesthesia, Stanford University, Stanford, CA, USA.
Juraj SprungDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Ravindra A GuptaDepartment of Anesthesiology and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Balachundhar SubramanianDepartment of Anesthesia, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Jadelis GiquelDepartment of Anesthesiology, University of Miami, Palmetto Bay, FL, USA.
Matthias EikermannDepartment of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
Guido MuschDepartment of Anesthesiology, University of Massachusetts, Worcester, MA, USA.
Jacob W NadlerDepartment of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, NY, USA.
Marcelo Gama de AbreuDivision of Intensive Care and Resuscitation and Outcomes Research Consortium, Department of Anesthesiology, Integrated Hospital-Care Institute, Cleveland Clinic, Cleveland, OH, USA.
Karsten BartelsDepartment of Anesthesiology, University of Nebraska Medical Center, Omaha, NE, USA.
Meera GroverDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Lee-Lynn ChenDepartment of Anesthesiology, University of California San Francisco, San Francisco, CA, USA.
Jamie SparlingDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
David J DouinDepartment of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA.
Toby WeingartenDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Gebhard WagenerDepartment of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA.
B Taylor ThompsonDivision of Pulmonary and Critical Care, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Marcos F Vidal MeloDepartment of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA; Department of Anesthesiology, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: mfvidalm@utmb.edu.
Perioperative Research Network (PRN) Investigators

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
1/2: An Anesthesia-Centered Bundle to Reduce Postoperative Pulmonary Complications: The PRIME-AIR StudyUH3HL140177 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI FERNANDEZ-BUSTAMANTE, ANA, VIDAL MELO, MARCOS F · 2020 to 2023
$6.6M
2/2: An Anesthesia-Centered Bundle to Reduce Postoperative Pulmonary Complications: The PRIME-AIR Study.U24HL140109 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI PARKER, ROBERT A. · 2019 to 2023
$2.3M
1/2: An Anesthesia-Centered Bundle to Reduce Postoperative Pulmonary Complications: The PRIME-AIR StudyUG3HL140177 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI FERNANDEZ-BUSTAMANTE, ANA, VIDAL MELO, MARCOS F · 2019 to 2019
$1.2M
Restoring Endothelial Function After Traumatic Injury to Reduce ARDS and Multi-Organ DysfunctionK23HL165107 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI David J. Douin · 2023 to 2026
$759k
NCI NIH HHS P30 CA008748NHLBI NIH HHS K23 HL165107NHLBI NIH HHS U24 HL140109NHLBI NIH HHS UG3 HL140177NHLBI NIH HHS UH3 HL140177
6 · The paper itself

Abstract

backgroundPostoperative pulmonary complications (PPCs) are a leading cause of morbidity, death, and increased use of health-care resources. We aimed to determine whether a perioperative lung expansion bundle including individualised intraoperative management reduces PPC severity in patients undergoing major open abdominal surgery compared with usual care.

methodsIn this multicentre, randomised controlled phase 3 trial (PRIME-AIR), we enrolled adult patients (age ≥18 years) scheduled for an elective open abdominal surgery that would last at least 2 h, who were at intermediate or high risk for PPCs on the basis of their Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (a score of ≥26), and who had a BMI below 35 kg/m

findingsBetween Jan 24, 2020, and April 5, 2023, we screened 1462 patients, of whom 794 were enrolled and randomly assigned to treatment. The mITT population included 751 participants, of whom 379 (50%) were in the intervention bundle group and 372 (50%) were in the usual care group. Mean age was 61·8 years (SD 12·8); 360 (48%) of 751 patients were female and 391 (52%) were male; 572 (76%) were White, 44 (6%) were Black, 35 (5%) were Asian, and ten (1%) were other races or more than one race. Adherence to bundle components was high (72-98%). Patients in the intervention bundle group received higher mean PEEP (7·5 cmH

interpretationIn patients with a BMI of less than 35 kg/m

fundingUS National Institutes for Health National Heart, Lung, and Blood Institute.

Indexed as

AbdomenPerioperative CarePositive-Pressure RespirationPostoperative ComplicationsAdultAgedElective Surgical ProceduresFemaleHumansMaleMiddle AgedUnited States

Identifiers

PMID40020692
PMCPMC13372525

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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.