Letters Intraoperative protective mechanical ventilation

Intraoperative protective ventilation: too early to redefine management parameters?

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5126 (Published 30 September 2015) Cite this as: BMJ 2015;351:h5126
  1. Nahel Saied, associate professor of anesthesiology1,
  2. Mohammad A Helwani, assistant professor of anesthesiology and critical care2,
  3. Pratik P Pandharipande, professor of anesthesiology and critical care1
  1. 1Vanderbilt University Medical Center, Nashville, TN 37212, USA
  2. 2Washington University School of Medicine, St Louis, MO 63110, USA
  1. saiedn{at}mac.com

The attention to detail, use of a large representative dataset, and rigorous statistical approach in Ladha and colleagues’ study of intraoperative mechanical ventilation and postoperative respiratory complications all help advance our knowledge.1 However, important limitations mean that these data must be interpreted with caution, especially before changing ventilatory management practices for patients in the operating room.

In a retrospective analysis of prospectively collected data, the authors showed in both unmatched and propensity matched analyses that patients who had all three of low plateau pressures (Pplat), low tidal …

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