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Ventilation and outcomes following robotic-assisted abdominal surgery : an international, multicentre observational study

(2021) BRITISH JOURNAL OF ANAESTHESIA. 126(2). p.533-543
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Abstract
Background: International data on the epidemiology, ventilation practice, and outcomes in patients undergoing abdominal robotic-assisted surgery (RAS) are lacking. The aim of the study was to assess the incidence of postoperative pulmonary complications (PPCs), and to describe ventilator management after abdominal RAS. Methods: This was an international, multicentre, prospective study in 34 centres in nine countries. Patients >= 18 yr of age undergoing abdominal RAS were enrolled between April 2017 and March 2019. The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score was used to stratify for higher risk of PPCs (>= 26). The primary outcome was the incidence of PPCs. Secondary endpoints included the preoperative risk for PPCs and ventilator management. Results: Of 1167 subjects screened, 905 abdominal RAS patients were included. Overall, 590 (65.2%) patients were at increased risk for PPCs. Meanwhile, 172 (19%) patients sustained PPCs, which occurred more frequently in 132 (22.4%) patients at increased risk, compared with 40 (12.7%) patients at lower risk of PPCs (absolute risk difference: 12.2% [95% confidence intervals (CI), 6.8-17.6%]; P<0.001). Plateau and driving pressures were higher in patients at increased risk, compared with patients at low risk of PPCs, but no ventilatory variables were independently associated with increased occurrence of PPCs. Development of PPCs was associated with a longer hospital stay. Conclusions: One in five patients developed one or more PPCs (chiefly unplanned oxygen requirement), which was associated with a longer hospital stay. No ventilatory variables were independently associated with PPCs.
Keywords
Anesthesiology and Pain Medicine, abdominal surgery, intraoperative ventilation, postoperative pulmonary complications, robotic-assisted surgery, robotic surgery

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MLA
Queiroz, Veronica N. F., et al. “Ventilation and Outcomes Following Robotic-Assisted Abdominal Surgery : An International, Multicentre Observational Study.” BRITISH JOURNAL OF ANAESTHESIA, vol. 126, no. 2, 2021, pp. 533–43, doi:10.1016/j.bja.2020.08.058.
APA
Queiroz, V. N. F., da Costa, L. G. V., Takaoka, F., Pelosi, P., de Abreu, M. G., Schultz, M. J., … Woods, L. (2021). Ventilation and outcomes following robotic-assisted abdominal surgery : an international, multicentre observational study. BRITISH JOURNAL OF ANAESTHESIA, 126(2), 533–543. https://doi.org/10.1016/j.bja.2020.08.058
Chicago author-date
Queiroz, Veronica N.F., Luis Guilherme V. da Costa, Flavio Takaoka, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J. Schultz, Ary Serpa Neto, et al. 2021. “Ventilation and Outcomes Following Robotic-Assisted Abdominal Surgery : An International, Multicentre Observational Study.” BRITISH JOURNAL OF ANAESTHESIA 126 (2): 533–43. https://doi.org/10.1016/j.bja.2020.08.058.
Chicago author-date (all authors)
Queiroz, Veronica N.F., Luis Guilherme V. da Costa, Flavio Takaoka, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J. Schultz, Ary Serpa Neto, R.P. Barbosa, J. Canet, J.P. Cata, D.S. Cesar, R.C.F. Chaves, U.C. D’Orto, L.G.V. Da Costa, Luc De Baerdemaeker, J.R. Galdi, M. Gama de Abreu, V. Gottumukkala, S.N.T. Hemmes, M.W. Hollmann, A.F. Kalmar, R. Mariano, I. Matot, G. Mazzinari, G.H. Mills, P. Pelosi, I.P. Posso, V.N.F. Queiroz, M.J. Schultz, A. Serpa Neto, J. Sprung, F. Takaoka, A. Teruya, M.F. Vidal Melo, Aalok V. Agarwala, Louise Akeroyd, Francesco Andorlini, Lisa Anicetti, Massimo Antonelli, Bruno S. Arantes, Jose J. Ariño Irujo, Hanna Artsi, Renata Babian, Rogerio P. Barbosa, Doug Barker, Diletta Basagni, Nicola Basso, Joan Beltran, Vittorio Bocciero, Giulia Bonatti, Ernesto Boriati, Mauro Bravo, Luca Brazzi, Chris Brearton, Andrew Brennan, Adam M. Bulinski, Sara Cafagna, Andrea Cardoni, Paula Castelló Mora, Juan P. Cata, Daniel S. Cesar, Renato CF. Chaves, Lee-Lynn Chen, Srikanth Chukkambotla, Alessandra Ciccozzi, Danae Cilia, Sean Cope, Ulisses C. D’Orto, Luis Guilherme V. Da Costa, Claire Dalton, Alessandra Davi, Marina del Barrio De Bonis, Angelo Raffaele De Gaudio, Lucilla De Luca, Carlos C. Delgado, Atousa Deljou, Cecilia Di Ruscio, Sijgje M. Droger, Stephen Duberley, Leonid A. Eidelman, Alison Evans, Constanza Fabiani, Umberto Fasciano, Jennifer Firth-Gieben, Jillian Fitchett, Angela Fundarò, Jose Roberto Galdi, Verdiana Gallo, Mattia Gavagni, Vijaya Gottumukkala, Chris Graham, Manuel Granell Gil, Angelo Gratarola, Chiara Grillandini, Harald-Thomas Groeben, Nesrine Ismail, Reni Jacob, Chris Jones, Rebecca Jones, Alain Kalmar, Ritoo Kapoor, Leigh Kelliher, Wiebke Köhne, Joseph SHA. Koopman, Prasad Lanka, Jae-Woo Lee, Bernard Liban, Francesca Livi, Renato Mariano, Ruth Martinez Plumed, Idit Matot, Marta Mazzella, Stewart McClure, Martina McMonagle, Gary H. Mills, Lucia Mirabella, Concepción Monsalve, Angela Moon, Laura Morchio, Frances Morris, Lorenzo Motroni, Benedetta Mura, Alessandro Nerini, Elodia C. Noumedem Sonna, Neil Oakes, Marina Orlandi, Antonella Paladini, Anita Patil, Vishal Patil, Valentina Patrone, Paolo Pelosi, Angela Pinder, Alba Piroli, Irimar P. Posso, Veronica NF. Queiroz, Yosef S. Rabbu, Robert Rabenalt, Stefano Romagnoli, Ariel Ronen, Felipe Rothman, Patrick Rusagara, Andrea Russo, Moldovan Sabov, Thomas Saitta, Ary Serpa Neto, Nirav Shah, Neil Smith, Liliana Sollazzi, Juraj Sprung, Emma Stewart, Elizabeth Stones, Kim Storton, Flavio Takaoka, Beatriz Tena, Eleonora Terreni, Alexandre Teruya, Chiara Travaglia, Tanja A. Treschan, Henk Vanoverschelde, Harish Venkatesh, Marcos F. Vidal Melo, Gianluca Villa, Robbert Vossen, Stephen Webber, Toby N. Weingarten, Matt Willcocks, Luke Winslow, and Lindsey Woods. 2021. “Ventilation and Outcomes Following Robotic-Assisted Abdominal Surgery : An International, Multicentre Observational Study.” BRITISH JOURNAL OF ANAESTHESIA 126 (2): 533–543. doi:10.1016/j.bja.2020.08.058.
Vancouver
1.
Queiroz VNF, da Costa LGV, Takaoka F, Pelosi P, de Abreu MG, Schultz MJ, et al. Ventilation and outcomes following robotic-assisted abdominal surgery : an international, multicentre observational study. BRITISH JOURNAL OF ANAESTHESIA. 2021;126(2):533–43.
IEEE
[1]
V. N. F. Queiroz et al., “Ventilation and outcomes following robotic-assisted abdominal surgery : an international, multicentre observational study,” BRITISH JOURNAL OF ANAESTHESIA, vol. 126, no. 2, pp. 533–543, 2021.
@article{8692046,
  abstract     = {Background: International data on the epidemiology, ventilation practice, and outcomes in patients undergoing abdominal robotic-assisted surgery (RAS) are lacking. The aim of the study was to assess the incidence of postoperative pulmonary complications (PPCs), and to describe ventilator management after abdominal RAS.

Methods: This was an international, multicentre, prospective study in 34 centres in nine countries. Patients >= 18 yr of age undergoing abdominal RAS were enrolled between April 2017 and March 2019. The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score was used to stratify for higher risk of PPCs (>= 26). The primary outcome was the incidence of PPCs. Secondary endpoints included the preoperative risk for PPCs and ventilator management.

Results: Of 1167 subjects screened, 905 abdominal RAS patients were included. Overall, 590 (65.2%) patients were at increased risk for PPCs. Meanwhile, 172 (19%) patients sustained PPCs, which occurred more frequently in 132 (22.4%) patients at increased risk, compared with 40 (12.7%) patients at lower risk of PPCs (absolute risk difference: 12.2% [95% confidence intervals (CI), 6.8-17.6%]; P<0.001). Plateau and driving pressures were higher in patients at increased risk, compared with patients at low risk of PPCs, but no ventilatory variables were independently associated with increased occurrence of PPCs. Development of PPCs was associated with a longer hospital stay.

Conclusions: One in five patients developed one or more PPCs (chiefly unplanned oxygen requirement), which was associated with a longer hospital stay. No ventilatory variables were independently associated with PPCs.},
  author       = {Queiroz, Veronica N.F. and da Costa, Luis Guilherme V. and Takaoka, Flavio and Pelosi, Paolo and de Abreu, Marcelo Gama and Schultz, Marcus J. and Serpa Neto, Ary and Barbosa, R.P. and Canet, J. and Cata, J.P. and Cesar, D.S. and Chaves, R.C.F. and D’Orto, U.C. and Da Costa, L.G.V. and De Baerdemaeker, Luc and Galdi, J.R. and Gama de Abreu, M. and Gottumukkala, V. and Hemmes, S.N.T. and Hollmann, M.W. and Kalmar, A.F. and Mariano, R. and Matot, I. and Mazzinari, G. and Mills, G.H. and Pelosi, P. and Posso, I.P. and Queiroz, V.N.F. and Schultz, M.J. and Serpa Neto, A. and Sprung, J. and Takaoka, F. and Teruya, A. and Vidal Melo, M.F. and Agarwala, Aalok V. and Akeroyd, Louise and Andorlini, Francesco and Anicetti, Lisa and Antonelli, Massimo and Arantes, Bruno S. and Ariño Irujo, Jose J. and Artsi, Hanna and Babian, Renata and Barbosa, Rogerio P. and Barker, Doug and Basagni, Diletta and Basso, Nicola and Beltran, Joan and Bocciero, Vittorio and Bonatti, Giulia and Boriati, Ernesto and Bravo, Mauro and Brazzi, Luca and Brearton, Chris and Brennan, Andrew and Bulinski, Adam M. and Cafagna, Sara and Cardoni, Andrea and Castelló Mora, Paula and Cata, Juan P. and Cesar, Daniel S. and Chaves, Renato CF. and Chen, Lee-Lynn and Chukkambotla, Srikanth and Ciccozzi, Alessandra and Cilia, Danae and Cope, Sean and D’Orto, Ulisses C. and Da Costa, Luis Guilherme V. and Dalton, Claire and Davi, Alessandra and De Bonis, Marina del Barrio and De Gaudio, Angelo Raffaele and De Luca, Lucilla and Delgado, Carlos C. and Deljou, Atousa and Di Ruscio, Cecilia and Droger, Sijgje M. and Duberley, Stephen and Eidelman, Leonid A. and Evans, Alison and Fabiani, Constanza and Fasciano, Umberto and Firth-Gieben, Jennifer and Fitchett, Jillian and Fundarò, Angela and Galdi, Jose Roberto and Gallo, Verdiana and Gavagni, Mattia and Gottumukkala, Vijaya and Graham, Chris and Granell Gil, Manuel and Gratarola, Angelo and Grillandini, Chiara and Groeben, Harald-Thomas and Ismail, Nesrine and Jacob, Reni and Jones, Chris and Jones, Rebecca and Kalmar, Alain and Kapoor, Ritoo and Kelliher, Leigh and Köhne, Wiebke and Koopman, Joseph SHA. and Lanka, Prasad and Lee, Jae-Woo and Liban, Bernard and Livi, Francesca and Mariano, Renato and Martinez Plumed, Ruth and Matot, Idit and Mazzella, Marta and McClure, Stewart and McMonagle, Martina and Mills, Gary H. and Mirabella, Lucia and Monsalve, Concepción and Moon, Angela and Morchio, Laura and Morris, Frances and Motroni, Lorenzo and Mura, Benedetta and Nerini, Alessandro and Noumedem Sonna, Elodia C. and Oakes, Neil and Orlandi, Marina and Paladini, Antonella and Patil, Anita and Patil, Vishal and Patrone, Valentina and Pelosi, Paolo and Pinder, Angela and Piroli, Alba and Posso, Irimar P. and Queiroz, Veronica NF. and Rabbu, Yosef S. and Rabenalt, Robert and Romagnoli, Stefano and Ronen, Ariel and Rothman, Felipe and Rusagara, Patrick and Russo, Andrea and Sabov, Moldovan and Saitta, Thomas and Serpa Neto, Ary and Shah, Nirav and Smith, Neil and Sollazzi, Liliana and Sprung, Juraj and Stewart, Emma and Stones, Elizabeth and Storton, Kim and Takaoka, Flavio and Tena, Beatriz and Terreni, Eleonora and Teruya, Alexandre and Travaglia, Chiara and Treschan, Tanja A. and Vanoverschelde, Henk and Venkatesh, Harish and Vidal Melo, Marcos F. and Villa, Gianluca and Vossen, Robbert and Webber, Stephen and Weingarten, Toby N. and Willcocks, Matt and Winslow, Luke and Woods, Lindsey},
  issn         = {0007-0912},
  journal      = {BRITISH JOURNAL OF ANAESTHESIA},
  keywords     = {Anesthesiology and Pain Medicine,abdominal surgery,intraoperative ventilation,postoperative pulmonary complications,robotic-assisted surgery,robotic surgery},
  language     = {eng},
  number       = {2},
  pages        = {533--543},
  title        = {Ventilation and outcomes following robotic-assisted abdominal surgery : an international, multicentre observational study},
  url          = {http://dx.doi.org/10.1016/j.bja.2020.08.058},
  volume       = {126},
  year         = {2021},
}

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