Effects of lung-protective ventilation strategy on lung aeration loss and postoperative pulmonary complications in moderate-risk patients undergoing abdominal surgery

BACKGROUND: There is a controversy about whether the use of a lung-protective ventilation strategy(LPVS) can reduce the incidence of postoperative pulmonary complications (PPCs) and improve the clinical outcomes in moderate-risk patients were assessed by the Assess Respiratory Risk in Surgical Patients in Catalonia(ARISCAT). METHODS: One hundred moderate-risk patients predicted by the ARISCAT, scheduled to undergo abdominal surgery were randomized into two groups: conventional ventilation strategy group (G(0)) and lung-protective ventilation strategy group (G(1)). Lung ultrasonography (LUS) and the LUS score were performed before induction of anesthesia (T-0), 30min after extubation (T-1). and 24h (T-2), 72h (T-3) after surgery. The incidence and severity of PPCs within the postoperative 7 days, the duration of postoperative oxygen supplementation, and postoperative hospital stay (PHS) were recorded. RESULTS: The LUS score of both groups at T(1-)(3 )was higher than those at T-0 (P<0.05), moreover, the LUS score of G(1) was lower than that of G(0) at T1-3. The incidence of PPCs of G(1) (10.9%) was lower than that of G(0) (29.8%) (relative risk, 0.37; 95% confidence interval [CI], 0.14 to 0.93; P=0.02) and the severity of PPCs of G(1) were lower than those of G(0) (P<0.05). The PHS of G(1) was less than that of G(0) (8[7-10] vs. 9[8-11], P<0.05). CONCLUSIONS: The LPVS can decrease lung aeration loss assessed by LUS and reduce the incidence of PPCs in moderate-risk patients.