• Marc-Olivier Fischer, François Brotons, Anais R Briant, Koichi Suehiro, Waldemar Gozdzik, Christoph Sponholz, Idar Kirkeby-Garstad, Alexandre Joosten, Nigro NetoCaetanoCInstituto Dante Pazzanese de Cardiologia, São Paulo, Brazil., Jan Kunstyr, Jean-Jacques Parienti, Osama Abou-Arab, Alexandre Ouattara, and VENICE study group.
• Normandie Univ, UNICAEN, CHU de Caen Normandie, Service d'Anesthésie Réanimation, Caen, France. Electronic address: fischer-mo@chu-caen.fr.
• J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt A): 2344-2351.

ObjectivePostoperative pulmonary complications (PPC) remain a main issue after cardiac surgery. The objective was to report the incidence and identify risk factors of PPC after cardiac surgery.DesignAn international multicenter prospective study (42 international centers in 9 countries).ParticipantsA total of 707 adult patients who underwent cardiac surgery under cardiopulmonary bypass.InterventionsNone MEASUREMENTS AND MAIN RESULTS: During a study period of 2 weeks, the investigators included all patients in their respective centers and screened for PPCs. PPC was defined as the occurrence of at least 1 pulmonary complication among the following: atelectasis, pleural effusion, respiratory failure, respiratory infection, pneumothorax, bronchospasm, or aspiration pneumonitis. Among 676 analyzed patients, 373 patients presented with a PPC (55%). The presence of PPC was significantly associated with a longer intensive care length of stay and hospital length of stay. One hundred ninety (64%) patients were not intraoperatively ventilated during cardiopulmonary bypass. Ventilation settings were similar regarding tidal volume, respiratory rate, inspired oxygen. In the regression model, age, the Euroscore II, chronic obstructive pulmonary disease, preoxygenation modality, intraoperative positive end-expiratory pressure, the absence of pre- cardiopulmonary bypass ventilation, the absence of lung recruitment, and the neuromuscular blockade were associated with PPC occurrence.ConclusionBoth individual risk factors and ventilatory settings were shown to explain the high level of PPCs. These findings require further investigations to assess a bundle strategy for optimal ventilation strategy to decrease PPC incidence.Copyright © 2022 Elsevier Inc. All rights reserved.

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