Abstract:
BACKGROUND:Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE:We aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data. DESIGN:This is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study. SETTINGS:A total of 146 hospitals across 29 countries. PATIENTS:Adult patients requiring intra-operative ventilation during general anaesthesia for surgery. INTERVENTIONS:The cohort was randomly divided into a development subsample to construct a predictive model, and a subsample for validation. MAIN OUTCOME MEASURES:Prediction performance of developed models for PPCs. RESULTS:Of the 6063 patients analysed, 10.9% developed at least one PPC. Regression modelling identified 13 independent risk factors for PPCs: six patient characteristics [higher age, higher American Society of Anesthesiology (ASA) physical score, pre-operative anaemia, pre-operative lower SpO2 and a history of active cancer or obstructive sleep apnoea], two procedure-related features (urgent or emergency surgery and surgery lasting ≥ 1 h), and five intra-operative events [use of an airway other than a supraglottic device, the use of intravenous anaesthetic agents along with volatile agents (balanced anaesthesia), intra-operative desaturation, higher levels of positive end-expiratory pressures > 3 cmH2O and use of vasopressors]. The area under the receiver operating characteristic curve of the LAS VEGAS risk score for prediction of PPCs was 0.78 [95% confidence interval (95% CI), 0.76 to 0.80] for the development subsample and 0.72 (95% CI, 0.69 to 0.76) for the validation subsample. CONCLUSION:The LAS VEGAS risk score including 13 peri-operative characteristics has a moderate discriminative ability for prediction of PPCs. External validation is needed before use in clinical practice. TRIAL REGISTRATION:The study was registered at Clinicaltrials.gov, number NCT01601223.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Neto AS,da Costa LGV,Hemmes SNT,Canet J,Hedenstierna G,Jaber S,Hiesmayr M,Hollmann MW,Mills GH,Vidal Melo MF,Pearse R,Putensen C,Schmid W,Severgnini P,Wrigge H,Gama de Abreu M,Pelosi P,Schultz MJ,LAS VEGAS.doi
10.1097/EJA.0000000000000845subject
Has Abstractpub_date
2018-09-01 00:00:00pages
691-701issue
9eissn
0265-0215issn
1365-2346journal_volume
35pub_type
杂志文章,多中心研究abstract:BACKGROUND:Propofol may help to protect against ischaemic acute kidney injury (AKI); however, research on this topic is sparse. OBJECTIVE:The current study aimed to investigate whether there were differences in the incidence of postoperative AKI after lung resection surgery between patients who received propofol-based...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001020
更新日期:2019-09-01 00:00:00
abstract:CONTEXT:Previous research has shown that most patients are satisfied with their anaesthetic care. For those who are not the causes may be multifactorial including dissatisfaction with surgical outcomes. OBJECTIVES:We aimed to identify whether quality of recovery after anaesthesia and surgery measured in multiple domai...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0b013e328357e584
更新日期:2013-03-01 00:00:00
abstract::The anti-emetic effects of ondansetron and droperidol were evaluated in 134 ASA Grade I and II female patients, scheduled for laparoscopic cholecystectomy and minor gynaecological laparoscopic surgery, who were randomly assigned to receive ondansetron 4 mg or droperidol 75 micrograms kg-1 intravenously immediately aft...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00581.x
更新日期:1999-11-01 00:00:00
abstract::In a randomized, double-blind study, we administered placebo and diclofenac sodium 100 mg suppositories 1 h pre-operatively and on the first post-operative morning to 22 adult patients undergoing minor orthopaedic surgery. A standardized post-operative intravenous fluid regimen was instituted until oral fluids were to...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Septic encephalopathy is believed to be a result of neuro-inflammation possibly triggered by endotoxins, such as lipopolysaccharides (LPS). Modulation of the immune system is a property of volatile anaesthetics. OBJECTIVE:We aimed to investigate the systemic and cerebral inflammatory response in a LPS-induc...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000668
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It is known that esmolol, a short-acting beta1-blocker, reduces anaesthetic requirement. In this study, we evaluated whether a low dose of landiolol, a new ultra-short-acting beta1-blocker, can reduce the sevoflurane requirement. METHODS:Twenty-five patients undergoing hip surgery were randoml...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328318c6a9
更新日期:2009-01-01 00:00:00
abstract::We present a case of pulmonary embolism that occurred during the injection of lipiodol during transcatheter arterial chemoembolization under general anaesthesia. A 7-year-old child suffering from a large hepatoblastoma was admitted for arterial chemoembolization and carcinostatic administration. Pulmonary embolism due...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.2000.00759.x
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The present study compares the accuracy of a new continuous venous oxygenation monitoring system (PediaSat Oximetry Catheter) with laboratory blood oximetry in paediatric surgical patients. METHODS:Children and adolescents undergoing cardiac, orthopaedic or craniofacial surgery with major bloo...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/EJA.0b013e32833bf5c5
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The effects of bicarbonated Ringer's solution were evaluated and compared with those of acetated Ringer's, lactated Ringer's and Ringer's solutions in partially hepatectomized rabbits. METHOD:Animals were randomly divided into six groups (n = 6 in each group): a sham-operated group, an operate...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/s0265021505001043
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Continuous positive airway pressure (CPAP) prevents peri-operative atelectasis in adults, but its effect in children has not been quantified. OBJECTIVE:The aim of this study was to evaluate the role of CPAP in preventing postinduction and postoperative atelectasis in children under general anaesthesia. DES...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001351
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of the present study was to determine the dosage of remifentanil that must be added to thiopental 5 mg kg(-1) to provide excellent intubating conditions in 95% of patients. METHODS:Sixty-eight premedicated female American Society of Anesthesiologists class 1 and 2 patients were randoml...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e3283396341
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Adding various opioids to the local anaesthetic solution administrated intrathecally improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 10 microg added to 15 mg hyperbaric ropivacaine in patients undergoi...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021505000785
更新日期:2005-06-01 00:00:00
abstract::The initial disposition of propofol was reported to change when the administration was preceded by fentanyl. The pharmacokinetic profile of the induction dose of propofol (2 mg kg-1 body weight) was studied in 20 ASA I patients randomly allocated to receive fentanyl 1.5 microgram kg-1 (n = 12) or not (n = 8). Anaesthe...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32833f6f42
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:To determine if there is any significant difference between the effects of desflurane, isoflurane and sevoflurane on the QT interval, QT dispersion, heart rate corrected QT interval and QTc dispersion of the electrocardiogram. METHODS:The study was conducted in a prospective, double blind and ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021504007112
更新日期:2004-07-01 00:00:00
abstract::In this review, we shall consider the oral and intravenous fluid management of pregnant women during labour and operative delivery in the context of neuroaxial blockade. We shall also discuss the use of blood transfusion in the peripartum period, especially during postpartum haemorrhage. Current management of military...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2010-12-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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abstract::The molecular mechanism of volatile anaesthetic action on presynaptic glutamate release is not clear. An inhibitory effect on voltage-gated calcium channels has been proposed. The present study examines the effect of isoflurane on cytosolic free calcium and synaptic glutamate release from isolated nerve terminals. Syn...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract::Ringer's solution expands blood volume by between 20% and 25% in awake volunteers, but little is known about its volume effect during general anaesthesia. In 35 men with a mean age of 70 years, the power of various intra-operative factors to change blood volume as estimated by the haemoglobin dilution method were anal...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00313.x
更新日期:1998-07-01 00:00:00
abstract::We describe the case of a 36-year-old woman, with a previous history of recurrent abortion due to protein S deficiency, undergoing an elective Caesarean section at 39-weeks gestation. During pregnancy no signs of hypertension or cardiovascular disease were reported, but at the end of the surgical procedure, the patien...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:1999-04-01 00:00:00
abstract::The benefits of epidural anaesthesia combined with general anaesthesia were studied in young children scheduled for major abdominal surgical procedure (pull-through for Hirschsprung's disease). Two groups of nine children were studied receiving, respectively, general anaesthesia or general anaesthesia plus epidural an...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1987-09-01 00:00:00
abstract::Competency frameworks are based on what are considered to be the general essential qualities of a doctor. Competencies, being behavioural descriptors, need a strong link to clinical practice to allow trainers to observe and then use them in assessing trainees' performance. The emerging concept of entrustable professio...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2015-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Patients in cardiac surgery and critically ill patients often demonstrate either hypothermia or fever. In addition, owing to heart failure, they frequently require inotropic support. The relative effectiveness of modern inotropic agents at various temperatures has not yet been evaluated. Theref...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328330e9a0
更新日期:2009-11-01 00:00:00
abstract::There is an increasing body of evidence that volatile anaesthetics protect myocardium against ischaemic insult by a mechanism termed 'anaesthetic preconditioning'. Anaesthetic preconditioning and ischaemic preconditioning share several common mechanisms of action. Since ischaemic preconditioning has been demonstrated ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2007-09-01 00:00:00
abstract::Prolongation of the QT interval may produce potentially hazardous dysrhythmias. The effects on the QT interval of midazolam followed by administration of either vecuronium or atracurium have been investigated. Thirty patients, ASA I or II, without cardiovascular problems, electrolyte abnormalities or receiving any med...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:In polymorphonuclear leucocytes, phagocytosis and respiratory burst activity are mainly responsible for bacterial killing. We aimed to investigate the effects of anaesthesia with desflurane, sevoflurane and propofol on these functional activities of polymorphonuclear leucocytes in bronchoalveol...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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更新日期:2009-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Previous studies have shown that L-type voltage-sensitive Ca2+ channel blocking agents increased and the L-type Ca2+ channel activator Bay K 8644 reduced the general anaesthetic potency in animals. As the bispectral index correlates with the depth of sedation, we examined whether L-type Ca2+ ch...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
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更新日期:2003-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The study investigated the effect of intravenous dexmedetomidine on brachial plexus block in patients with end-stage renal disease sedated with dexmedetomidine or midazolam for the formation of arteriovenous fistula. METHODS:A supraclavicular brachial plexus block was performed in 68 patients ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32832a2244
更新日期:2009-10-01 00:00:00