Evaluation of Perioperative Ventilation Strategies: National Survey Study

Lung injury can develop in the perioperative period due to ventilation management techniques. Thus, the attitude of anaesthetists on protective ventilation (PV) practice comes into question. In our study, we aimed to evaluate the perioperative ventilation practice of anaesthetists and trainees on anaesthesiology by a survey study.

Survey form was sent to all doctors registered to TARD via electronic mail. The participants were asked questions involving PV parameters such as low tidal volume (TV) according to ideal body weight (BW), positive end-expiratory pressure (PEEP), FiO2 use and recruitment manoeuvre (RM) application. In total, 411 doctors who answered the survey were included to the study. Application rates of PV parameters and causes were compared within the answers obtained. P<0.05 was accepted statistically significant.

PV was practised by 19.4% of the participants. Those who preferred low TV used ideal BW more frequently (p<0.001). PEEP of 4-6 cm H2O was commonly used (p<0.001). The participants mostly preferred FiO2 of 1.0 (60.4%), and application rate of RM was found to be 17.2%. The use of all PV parameters was detected to be higher among instructors than among other groups.

In our study, application ratio of PV with all its parameters was found to be lower. Among the parameters, while low TV according to ideal BW and PEEP were applied at higher ratios, the use of RM and low oxygen percentage were applied less frequently. While PV was found to be useful in terms of perioperative ventilation strategies, low practice rates may result from habits besides lack of knowledge and experience; comprehensive and quality education studies are needed to overcome this.