Predictive value of the respiratory exchange ratio for the occurrence of postoperative complications in laparoscopic surgery: a prospective and observational study
Indirect measurement of the respiratory exchange ratio (RER) has been shown to predict the occurrence of postoperative complications after major open non-cardiac surgery. Our main objective was to demonstrate the ability of the RER, indirectly measured by the anaesthesia respirator, to predict the o...
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| Veröffentlicht in: | Journal of clinical monitoring and computing 2021-08, Vol.35 (4), p.849-858 |
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| creator | Bar, Stéphane Santarelli, Dimitri de Broca, Bruno Abou Arab, Osama Leviel, Florent Miclo, Matthieu Dupont, Hervé Guinot, Pierre-Grégroire Lorne, Emmanuel |
| description | Indirect measurement of the respiratory exchange ratio (RER) has been shown to predict the occurrence of postoperative complications after major open non-cardiac surgery. Our main objective was to demonstrate the ability of the RER, indirectly measured by the anaesthesia respirator, to predict the occurrence of postoperative complications following laparoscopic surgery. We performed an observational, prospective and monocentric study. Haemodynamic and respiratory parameters were collected at several timepoints to calculate the RER by a non-volumetric method: RER = (FetCO
2
–FiCO
2
)/(FiO
2
–FetO
2
). Fifty patients were prospectively included. Nine patients (18%) had at least one postoperative complication. The mean RER was significantly higher for the subgroup of patients with complications than the subgroup without (1.04 ± 0.27
vs
0.88 ± 0.13, p |
| doi_str_mv | 10.1007/s10877-020-00544-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03576422v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2552758867</sourcerecordid><originalsourceid>FETCH-LOGICAL-c386t-62b04b3fa813ce173d84586ef0552b7afd1ba6eedbac5c1d6e6ece94f7d7b5253</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhSMEEqXtC7CyxAYWAf_EP8OuqgqtNBJd0LV149x0XGViYyejzvPwojgTBBILVraOvnN07FNVbxn9yCjVnzKjRuuaclpTKpumli-qMya1qLlizctyF0bXTFD9unqT8xOldGMEO6t-3ifsvJv8AckBhhlJ6Mm0Q5IwR59gCulI8NntYHwsIkw-kD6kExKcm1PC0Z1MMeQpRFyQkuXCPg7eLfyYiR_JABFSyC5E70ie0yOm42cCJBYx4loAxo6ENmM6nHwwkDzN3fGietXDkPHy93lePXy5-X59W2-_fb27vtrWThg11Yq3tGlFD4YJh0yLzjTSKOyplLzV0HesBYXYteCkY51ChQ43Ta873UouxXn1Yc3dwWBj8ntIRxvA29urrV00KqRWDecHVtj3K1v6_5gxT3bvs8NhgBHDnC1vGN8YLTgv6Lt_0Kcwp_K6QpVmWhqjdKH4SrnyITlh_6cBo3bZ2K4b27KxPW1sl8ZiNeUCl4HS3-j_uH4BpK6uUA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2552758867</pqid></control><display><type>article</type><title>Predictive value of the respiratory exchange ratio for the occurrence of postoperative complications in laparoscopic surgery: a prospective and observational study</title><source>SpringerLink Journals</source><creator>Bar, Stéphane ; Santarelli, Dimitri ; de Broca, Bruno ; Abou Arab, Osama ; Leviel, Florent ; Miclo, Matthieu ; Dupont, Hervé ; Guinot, Pierre-Grégroire ; Lorne, Emmanuel</creator><creatorcontrib>Bar, Stéphane ; Santarelli, Dimitri ; de Broca, Bruno ; Abou Arab, Osama ; Leviel, Florent ; Miclo, Matthieu ; Dupont, Hervé ; Guinot, Pierre-Grégroire ; Lorne, Emmanuel</creatorcontrib><description>Indirect measurement of the respiratory exchange ratio (RER) has been shown to predict the occurrence of postoperative complications after major open non-cardiac surgery. Our main objective was to demonstrate the ability of the RER, indirectly measured by the anaesthesia respirator, to predict the occurrence of postoperative complications following laparoscopic surgery. We performed an observational, prospective and monocentric study. Haemodynamic and respiratory parameters were collected at several timepoints to calculate the RER by a non-volumetric method: RER = (FetCO
2
–FiCO
2
)/(FiO
2
–FetO
2
). Fifty patients were prospectively included. Nine patients (18%) had at least one postoperative complication. The mean RER was significantly higher for the subgroup of patients with complications than the subgroup without (1.04 ± 0.27
vs
0.88 ± 0.13, p < 0.05). The RER could predict the occurrence of post-operative complications with an area under the ROC curve of 0.73 (95% CI 0.59–0.85, p = 0.021). The best cut off was 0.98, with a sensitivity of 56% and a specificity of 88%. One hour after insufflation, the FiO
2
–FetO
2
difference was significantly lower and the RER was significantly higher in the complications subgroup than in the subgroup without complications (4.4/− 1.6%
vs
5.8/− 1.2%, p = 0.001 and 0.95 [0.85–1.04]
vs
0.83 [0.75–0.92], p = 0.04, respectively). The RER measured during laparoscopic surgery can predict the occurrence of postoperative complications.
Trial registration
The objectives and procedures of the study was registered at Clinicaltrials.gov (NCT03751579); date: November 23, 2018.</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-020-00544-5</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Anesthesia ; Anesthesiology ; Critical Care Medicine ; Health Sciences ; Hemodynamics ; Intensive ; Laparoscopy ; Life Sciences ; Medicine ; Medicine & Public Health ; Observational studies ; Original Research ; Statistics for Life Sciences ; Subgroups ; Surgery</subject><ispartof>Journal of clinical monitoring and computing, 2021-08, Vol.35 (4), p.849-858</ispartof><rights>Springer Nature B.V. 2020</rights><rights>Springer Nature B.V. 2020.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-62b04b3fa813ce173d84586ef0552b7afd1ba6eedbac5c1d6e6ece94f7d7b5253</citedby><cites>FETCH-LOGICAL-c386t-62b04b3fa813ce173d84586ef0552b7afd1ba6eedbac5c1d6e6ece94f7d7b5253</cites><orcidid>0000-0002-4630-5833 ; 0000-0002-5644-3412 ; 0000-0003-3766-716X ; 0000-0001-6409-5449</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10877-020-00544-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10877-020-00544-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://u-picardie.hal.science/hal-03576422$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Bar, Stéphane</creatorcontrib><creatorcontrib>Santarelli, Dimitri</creatorcontrib><creatorcontrib>de Broca, Bruno</creatorcontrib><creatorcontrib>Abou Arab, Osama</creatorcontrib><creatorcontrib>Leviel, Florent</creatorcontrib><creatorcontrib>Miclo, Matthieu</creatorcontrib><creatorcontrib>Dupont, Hervé</creatorcontrib><creatorcontrib>Guinot, Pierre-Grégroire</creatorcontrib><creatorcontrib>Lorne, Emmanuel</creatorcontrib><title>Predictive value of the respiratory exchange ratio for the occurrence of postoperative complications in laparoscopic surgery: a prospective and observational study</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><description>Indirect measurement of the respiratory exchange ratio (RER) has been shown to predict the occurrence of postoperative complications after major open non-cardiac surgery. Our main objective was to demonstrate the ability of the RER, indirectly measured by the anaesthesia respirator, to predict the occurrence of postoperative complications following laparoscopic surgery. We performed an observational, prospective and monocentric study. Haemodynamic and respiratory parameters were collected at several timepoints to calculate the RER by a non-volumetric method: RER = (FetCO
2
–FiCO
2
)/(FiO
2
–FetO
2
). Fifty patients were prospectively included. Nine patients (18%) had at least one postoperative complication. The mean RER was significantly higher for the subgroup of patients with complications than the subgroup without (1.04 ± 0.27
vs
0.88 ± 0.13, p < 0.05). The RER could predict the occurrence of post-operative complications with an area under the ROC curve of 0.73 (95% CI 0.59–0.85, p = 0.021). The best cut off was 0.98, with a sensitivity of 56% and a specificity of 88%. One hour after insufflation, the FiO
2
–FetO
2
difference was significantly lower and the RER was significantly higher in the complications subgroup than in the subgroup without complications (4.4/− 1.6%
vs
5.8/− 1.2%, p = 0.001 and 0.95 [0.85–1.04]
vs
0.83 [0.75–0.92], p = 0.04, respectively). The RER measured during laparoscopic surgery can predict the occurrence of postoperative complications.
Trial registration
The objectives and procedures of the study was registered at Clinicaltrials.gov (NCT03751579); date: November 23, 2018.</description><subject>Anesthesia</subject><subject>Anesthesiology</subject><subject>Critical Care Medicine</subject><subject>Health Sciences</subject><subject>Hemodynamics</subject><subject>Intensive</subject><subject>Laparoscopy</subject><subject>Life Sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Observational studies</subject><subject>Original Research</subject><subject>Statistics for Life 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value of the respiratory exchange ratio for the occurrence of postoperative complications in laparoscopic surgery: a prospective and observational study</title><author>Bar, Stéphane ; Santarelli, Dimitri ; de Broca, Bruno ; Abou Arab, Osama ; Leviel, Florent ; Miclo, Matthieu ; Dupont, Hervé ; Guinot, Pierre-Grégroire ; Lorne, Emmanuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-62b04b3fa813ce173d84586ef0552b7afd1ba6eedbac5c1d6e6ece94f7d7b5253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anesthesia</topic><topic>Anesthesiology</topic><topic>Critical Care Medicine</topic><topic>Health Sciences</topic><topic>Hemodynamics</topic><topic>Intensive</topic><topic>Laparoscopy</topic><topic>Life Sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Observational studies</topic><topic>Original Research</topic><topic>Statistics for Life 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study</atitle><jtitle>Journal of clinical monitoring and computing</jtitle><stitle>J Clin Monit Comput</stitle><date>2021-08-01</date><risdate>2021</risdate><volume>35</volume><issue>4</issue><spage>849</spage><epage>858</epage><pages>849-858</pages><issn>1387-1307</issn><eissn>1573-2614</eissn><abstract>Indirect measurement of the respiratory exchange ratio (RER) has been shown to predict the occurrence of postoperative complications after major open non-cardiac surgery. Our main objective was to demonstrate the ability of the RER, indirectly measured by the anaesthesia respirator, to predict the occurrence of postoperative complications following laparoscopic surgery. We performed an observational, prospective and monocentric study. Haemodynamic and respiratory parameters were collected at several timepoints to calculate the RER by a non-volumetric method: RER = (FetCO
2
–FiCO
2
)/(FiO
2
–FetO
2
). Fifty patients were prospectively included. Nine patients (18%) had at least one postoperative complication. The mean RER was significantly higher for the subgroup of patients with complications than the subgroup without (1.04 ± 0.27
vs
0.88 ± 0.13, p < 0.05). The RER could predict the occurrence of post-operative complications with an area under the ROC curve of 0.73 (95% CI 0.59–0.85, p = 0.021). The best cut off was 0.98, with a sensitivity of 56% and a specificity of 88%. One hour after insufflation, the FiO
2
–FetO
2
difference was significantly lower and the RER was significantly higher in the complications subgroup than in the subgroup without complications (4.4/− 1.6%
vs
5.8/− 1.2%, p = 0.001 and 0.95 [0.85–1.04]
vs
0.83 [0.75–0.92], p = 0.04, respectively). The RER measured during laparoscopic surgery can predict the occurrence of postoperative complications.
Trial registration
The objectives and procedures of the study was registered at Clinicaltrials.gov (NCT03751579); date: November 23, 2018.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><doi>10.1007/s10877-020-00544-5</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-4630-5833</orcidid><orcidid>https://orcid.org/0000-0002-5644-3412</orcidid><orcidid>https://orcid.org/0000-0003-3766-716X</orcidid><orcidid>https://orcid.org/0000-0001-6409-5449</orcidid></addata></record> |
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| ispartof | Journal of clinical monitoring and computing, 2021-08, Vol.35 (4), p.849-858 |
| issn | 1387-1307 1573-2614 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03576422v1 |
| source | SpringerLink Journals |
| subjects | Anesthesia Anesthesiology Critical Care Medicine Health Sciences Hemodynamics Intensive Laparoscopy Life Sciences Medicine Medicine & Public Health Observational studies Original Research Statistics for Life Sciences Subgroups Surgery |
| title | Predictive value of the respiratory exchange ratio for the occurrence of postoperative complications in laparoscopic surgery: a prospective and observational study |
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