The overall objective of this study is to describe the incidence of postoperative pulmonary complications in patients with a positive and negative AIR-test result. Second, the investigators wish to describe the incidence of a positive AIR-test and its association with the development of PPC. In addition, the investigators aim to describe whether mechanical ventilation strategy differs between patients with a positive and negative AIR-test.
The 'AIR-test', a method wherein inspiratory oxygen concentration is reduced to 21% and pulse-oximetry hemoglobin saturation (SpO2) is monitored, can be used to demonstrate the presence of an atelectasis-induced alveolar shunt. It remains uncertain whether an intraoperative positive AIR-test is associated with clinical outcomes. It is hypothesized that in a general surgical population, the incidence of postoperative pulmonary complications (PPC) is higher in patients with a positive AIR-test than in patients with a negative AIR-test. The aim of this study is to describe the incidence of PPC in patients with a positive and in patients with a negative AIR-test. Second, the investigators want to describe the incidence of a positive AIR-test and its association with the development of PPC. The investigators also want to evaluate whether mechanical ventilation strategy differs between patients with a positive and negative AIR-test.
Study Type
OBSERVATIONAL
Enrollment
632
All types of surgery requiring general anesthesia
Amsterdam University Medical Centers
Amsterdam, North Holland, Netherlands
The incidence of postoperative pulmonary complications
Respiratory failure; Bronchospasm; Acute Respiratory Distress Syndrome (ARDS); Suspected pulmonary infection; Aspiration pneumonitis; Atelectasis; Pleural effusion; Pulmonary infiltrate; Cardiopulmonary effusion; Pneumothorax
Time frame: The first 5 postoperative days
AIR-test result
Number of patients with a positive and negative AIR-test
Time frame: Intraoperative period
Tidal volume during general anesthesia for surgery
Tidal volume in mL per kg predicted bodyweight
Time frame: Intraoperative period
Positive End-Expiratory Pressure during general anesthesia for surgery
Positive End-Expiratory Pressure in Centimeters of Water (cmH2O)
Time frame: Intraoperative period
Peak Pressure during general anesthesia for surgery
Peak Pressure in cmH20
Time frame: Intraoperative period
Driving Pressure during general anesthesia for surgery
Driving Pressure in cmH2O
Time frame: Intraoperative period
Fraction of Inspired Oxygen during general anesthesia for surgery
Fraction of Inspired Oxygen
Time frame: Intraoperative period
End-tidal Carbon Dioxide (CO2) during general anesthesia for surgery
End-tidal CO2 in millimeters of mercury (mmHg)
Time frame: Intraoperative period
Respiratory Rate during general anesthesia for surgery
Respiratory Rate per minute
Time frame: Intraoperative period
The incidence of the individual components of postoperative pulmonary complications
Respiratory failure; Bronchospasm; ARDS; Suspected pulmonary infection; Aspiration pneumonitis; Atelectasis; Pleural effusion; Pulmonary infiltrate; Cardiopulmonary effusion; Pneumothorax
Time frame: The first 5 postoperative days
Length of hospital stay
Days of hospital stay
Time frame: From the day of surgery until the day of discharge, up to day 30
Rate of all-cause mortality and in-hospital mortality
Mortality rate
Time frame: Postoperative day 5 and postoperative day 30
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