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Table 6 Summary of mortality outcome for ventilation interventions for a significant difference in mortality

From: Anesthesia interventions that alter perioperative mortality: a scoping review

First author, year Type of surgery, no. of participants Intervention/comparison details Perioperative phase, duration of intervention Impact on mortality* (outcome definition, timing)
Antonelli, 2000 General or Thoracic, 40 Non-invasive ventilation: “…the ventilator was connected with conventional tubing to a clear, full face mask with an inflatable soft cushion seal and a disposable foam spacer to reduce dead space. After the mask was secured, pressure support was increased to obtain an exhaled tidal volume of 8 to 10 mL/kg, a respiratory rate of fewer than 25 per minute, the disappearance of accessory muscle activity (as evaluated by palpating the sternocleidomastoid muscle), and patient comfort. Positive end-expiratory pressure was increased in increments of 2 to 3 cm H2O repeatedly up to 10 cm H2O until the FiO2 requirement was 0.6 or less.”
Standard treatment with supplemental oxygen administration
Postoperative
“During the first 24 h, ventilation was continuously maintained until oxygenation and clinical status improved. Subsequently, each patient was evaluated daily while breathing supplemental oxygen without ventilatory support for 15 min. Non-invasive ventilation was reduced progressively in accordance with the degree of clinical improvement and was discontinued if the patient maintained a respiratory rate lower than 30 per minute and a PaO2 greater than 75 mmHg with a FiO2 of 0.5 without ventilatory support.”
Decreased mortality (rate of fatal complications, in-hospital, primary outcome)
Auriant, 2001 Thoracic, 48 NPVV: “Ventilation was provided via a cushion bridge nasal mask (Profil lite; Respironics.Inc., Murrysville, PA). NPPV was provided with the BiPAP S/T-D Ventilatory Support System (Bipap Vision; Respironics, Inc.). Pressure support was increased to achieve an exhaled tidal volume of 8 to 10 mL/kg and a respiratory rate of less than 25 breaths per minute. The FiO2 was adjusted to obtain a percutaneous oxygen saturation above 90%.”
Standard treatment: “All patients received oxygen supplementation to achieve an SaO2 above 90%, bronchodilators (aerosolized albuterol), patient-controlled analgesia (PCA) (bolus dose = 1 mg morphine, lockout interval 7 min, maximum hourly dose = 7 mg), and chest physiotherapy.”
Postoperative
“The duration of ventilation was standardized according to Wysocki and coworkers.”
Decreased mortality (in-hospital and 120 days, secondary outcomes)
Lobo, 2000 Major oncological or vascular surgery, 37 Increased oxygen levels to > 600 ml/min/m2 in patients post-major oncological or vascular surgery.
Control group maintained oxygen delivery at 520–600 ml/min/m2
Intraoperative, postoperative
For the first 24 h of postop ICU admission
ND (28-day mortality, primary outcome)
Decreased mortality (60-day mortality, primary outcome)
Meyoff, 2012 General, 1382 After tracheal intubation, patients were given an FiO2 of 0.80 or 0.30 according to the randomization
Usual care: receive 30% oxygen during and for 2 h after surgery
Intraoperative, postoperative
During most of the intraoperative phase
Increased mortality (all-cause mortality at 2 years, primary outcome)
Zhu, 2013 Cardiac, 95 Non-invasive positive pressure ventilation (NPPV). “NPPV therapy was administered using the bilevel positive airways pressure (BiPAP) S/T mode (Resmed, VPAP III, Australia) via a properly fitted face mask (ZS-MZ-, Zhongshan Technique Development Co., Shanghai)… The initial inspiratory pressure (IPAP) was set at 12 cmH2O… According to clinical efficacy and patient tolerance, we raised the IPAP and (or) EPAP by 2–3 cmH2O every 5 to 10 min…All patients continued to receive NPPV except for coughing, eating, and talking until their condition was improved. Then NPPV was administered intermittently and the IPAP/EPAP was decreased gradually.”
“Standard medical care and oxygen therapy as needed.”
Postoperative
Until the condition improved.
Decreased mortality (in-hospital mortality, primary)
  1. Anesthesia-related intervention refers to interventions provided in the perioperative period that was or could be performed, organized, or initiated by a healthcare professional with specific training in anesthesia
  2. ND no significant change, NR not reported