Clinical practice of intraoperative ventilation management of adult patients undergoing non-cardiothoracic surgery: a regional questionnaire survey / 中华麻醉学杂志

ABSTRACT

Objective:To investigate the development of clinical practice of intraoperative ventilation management of the adult patients undergoing non-cardiothoracic surgery using surveys and questionnaires.Methods:From December 2020 to January 2021, an electronic questionnaire was sent to the anesthesiologists in twenty-nine tertiary general hospitals in Sichuan province.Results:A total of 1 264 valid questionnaires were received with a response rate of 78.50%.The proportion of anesthesiologists who utilized low tidal volume (V T) during surgery was 90.43%.The proportion of anesthesiologists who utilized positive end-expiratory pressure (PEEP) during surgery was 70.73%, and the level of PEEP was controlled at 1-5 cmH 2O by most of the anesthesiologists (77.4% in laparoscopic surgery and 88.4% in non-cardiothoracic surgery). The proportion of anesthesiologists who performed alveolar recruitment maneuvers (ARM) was 82.28%.The proportion of anesthesiologists who used a combination of low V T, PEEP and ARM was 37.03%.The proportion of anesthesiologists who considered "low V T, appropriate use of PEEP or ARM" as "intraoperative lung-protective ventilation (LPV) strategy" was 98.10%.However, the other ventilation settings such as the fraction of inspired oxygen, respiratory rate and ventilation mode varied among anesthesiologists in clinical practice. Conclusion:LPV strategy recognized by anesthesiologists in the large-scale tertiary general hospitals in Sichuan province includes low V T, PEEP and ARM, however, there is a gap between clinical practice and theoretical cognition.