Current ventilation practice during general anaesthesia: a prospective audit in Melbourne, Australia
Dharshi Karalapillai1, Laurence Weinberg2, Jonathan Galtieri3
1Department of Intensive Care, Austin Hospital, Melbourne, Australia ; Department of Anaesthesia, Austin Hospital, Melbourne, Australia.
Australian anaesthesia practice shows high tidal volumes and modest positive end-expiratory pressure (PEEP) use in mechanically ventilated patients. This differs from control groups in prior studies, highlighting a gap in current clinical application.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Respiratory Physiology
Background:
- Low tidal volume ventilation and PEEP may reduce respiratory complications during general anaesthesia.
- Current Australian practice regarding these ventilation strategies is not well-documented.
Purpose of the Study:
- To audit intraoperative mechanical ventilation practices in Australia.
- Specifically examining tidal volume and PEEP application during general anaesthesia.
Main Methods:
- A multicentre audit of 272 patients undergoing general anaesthesia.
- Data collected included tidal volume, PEEP use, patient demographics, and surgery type across eight Melbourne teaching hospitals.
Main Results:
- Median tidal volume was 500 ml (9.5 ml/kg predicted body weight).
- Positive end-expiratory pressure (PEEP) was used in 54% of patients at a median of 5 cmH2O.
- Higher tidal volumes were predicted by male sex, height, and weight; PEEP use was associated with tertiary hospital surgery and longer duration.
Conclusions:
- Mechanical ventilation in Australian anaesthesia commonly uses high tidal volumes and PEEP at modest levels.
- Current practices may not align with control groups in previous randomized controlled trials.
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