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Article: Postoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation

TitlePostoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation
Authors
Keywordsmechanical ventilation
older patients
postoperative pulmonary complications
supraglottic airway device
tracheal intubation
Issue Date4-Jun-2023
PublisherWiley
Citation
Anaesthesia: Peri-operative medicine, critical care and pain, 2023, v. 78, n. 8, p. 953-962 How to Cite?
AbstractThe two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non-cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in-hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged >= 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1-2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference -5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra-operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.
Persistent Identifierhttp://hdl.handle.net/10722/328988
ISSN
2023 Impact Factor: 7.5
2023 SCImago Journal Rankings: 2.400
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYang, LQ-
dc.contributor.authorZhu, L-
dc.contributor.authorShi, X-
dc.contributor.authorMiao, CH-
dc.contributor.authorYuan, HB-
dc.contributor.authorLiu, ZQ-
dc.contributor.authorGu, WD-
dc.contributor.authorLiu, F-
dc.contributor.authorHu, XX-
dc.contributor.authorShi, DP-
dc.contributor.authorDuan, HW-
dc.contributor.authorWang, CY-
dc.contributor.authorWeng, H-
dc.contributor.authorHuang, ZL-
dc.contributor.authorLi, LZ-
dc.contributor.authorHe, ZZ-
dc.contributor.authorLi, J-
dc.contributor.authorHu, YP-
dc.contributor.authorLin, L-
dc.contributor.authorPan, ST-
dc.contributor.authorXu, SH-
dc.contributor.authorTang, D-
dc.contributor.authorSessler, DI-
dc.contributor.authorLiu, J-
dc.contributor.authorIrwin, MG-
dc.contributor.authorYu, WF-
dc.contributor.authorPOLMA-EP Investigators,-
dc.date.accessioned2023-08-05T07:54:26Z-
dc.date.available2023-08-05T07:54:26Z-
dc.date.issued2023-06-04-
dc.identifier.citationAnaesthesia: Peri-operative medicine, critical care and pain, 2023, v. 78, n. 8, p. 953-962-
dc.identifier.issn0003-2409-
dc.identifier.urihttp://hdl.handle.net/10722/328988-
dc.description.abstractThe two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non-cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in-hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged >= 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1-2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference -5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra-operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.-
dc.languageeng-
dc.publisherWiley-
dc.relation.ispartofAnaesthesia: Peri-operative medicine, critical care and pain-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectmechanical ventilation-
dc.subjectolder patients-
dc.subjectpostoperative pulmonary complications-
dc.subjectsupraglottic airway device-
dc.subjecttracheal intubation-
dc.titlePostoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation-
dc.typeArticle-
dc.identifier.doi10.1111/anae.16030-
dc.identifier.pmid37270923-
dc.identifier.scopuseid_2-s2.0-85161447126-
dc.identifier.volume78-
dc.identifier.issue8-
dc.identifier.spage953-
dc.identifier.epage962-
dc.identifier.eissn1365-2044-
dc.identifier.isiWOS:001000308300001-
dc.publisher.placeHOBOKEN-
dc.identifier.issnl0003-2409-

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