Association of intraoperative mechanical power of ventilation with occurrence of postoperative respiratory failure in patients undergoing major abdominal onco-surgery in a tertiary cancer centre - A prospective analytical study.

Background and Aims: Mechanical power (MP) is the energy transferred to the respiratory system and the lung during mechanical ventilation. The interaction between the anatomical and physiological characteristics of the lung parenchyma and the MP transferred to it during ventilation determines the extent of lung injury. This study aims to assess the association between MP and the development of postoperative pulmonary complications (PPCs) within the first seven postoperative days in adult patients receiving mechanical ventilation during major abdominal onco-surgery. Methods: After obtaining approval from the institutional ethics committee, written informed consent was obtained from all participants. Patients aged 18-80 years undergoing major abdominal onco-surgery under general anaesthesia with mechanical ventilation for more than 3 hours were included in the study. Intraoperative ventilatory parameters were recorded. Predictors for the development of respiratory complications during the first seven days postoperatively were analysed using logistic regression. Results: The cut-off value for intraoperative MP obtained from the receiver operator curve [area under the curve: (AUC)=0.927; Conclusion: Our study explored the relationship between MP applied to the lungs intraoperatively and the development of RF postoperatively. Our findings suggest that intraoperative MP is a strong, independent predictor of postoperative respiratory failure.