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Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in patients without acute lung injury

Overview of attention for article published in Cochrane database of systematic reviews, December 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (79th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

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8 tweeters
facebook
4 Facebook pages

Citations

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36 Dimensions

Readers on

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17 Mendeley
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Title
Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in patients without acute lung injury
Published in
Cochrane database of systematic reviews, December 2015
DOI 10.1002/14651858.cd011151.pub2
Pubmed ID
Authors

Joanne Guay, Edward A Ochroch

Abstract

During the last decade, there has been a trend towards decreasing tidal volumes for positive pressure ventilation during surgery. It is not known whether this new trend is beneficial or harmful for patients. To assess the benefit of intraoperative use of low tidal volume ventilation (< 10 mL/kg of predicted body weight) to decrease postoperative complications. We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2014, Issue 9), MEDLINE (OvidSP) (from 1946 to 5 September 2014) and EMBASE (OvidSP) (from 1974 to 5 September 2014). We included all parallel randomized controlled trials (RCTs) that evaluated the effect of low tidal volumes (defined as < 10 mL/kg) on any of our selected outcomes in adult participants undergoing any type of surgery. We did not retain studies with participants requiring one-lung ventilation. Two authors independently assessed the quality of the retained studies with the Cochrane 'Risk of bias' tool. We analysed data with both fixed-effect (I(2) statistic < 25%) or random-effects (I(2) statistic > 25%) models based on the degree of heterogeneity. When there was an effect, we calculated a number needed to treat for an additional beneficial outcome (NNTB) using the odds ratio. When there was no effect, we calculated the optimal size information. We included 12 studies in the review. In total these studies detailed 1012 participants (499 participants in the low tidal volume group and 513 in the high volume group). All studies included were at risk of bias as defined by the Cochrane tool. Based on nine studies including 899 participants, we found no difference in 0- to 30-day mortality between low and high tidal volume groups (risk ratio (RR) 0.79, 95% confidence interval (CI) 0.40 to 1.54; I(2) statistic 0%; low quality evidence). Based on four studies including 601 participants undergoing abdominal or spinal surgery, we found a lower incidence of postoperative pneumonia in the lower tidal volume group (RR 0.44, 95% CI 0.20 to 0.99; I(2) statistic 19%; moderate quality evidence; NNTB 19, 95% CI 14 to 169). Based on two studies including 428 participants, low tidal volumes decreased the need for non-invasive postoperative ventilatory support (RR 0.31, 95% CI 0.15 to 0.64; moderate quality evidence; NNTB 11, 95% CI 9 to 19). Based on eight studies including 814 participants, low tidal volumes during surgery decreased the need for postoperative invasive ventilatory support (RR 0.33, 95% CI 0.14 to 0.80; I(2) statistic 0%; NNTB 36, 95% CI 27 to 202; moderate quality evidence). Based on three studies including 650 participants, we found no difference in the intensive care unit length of stay (standardized mean difference (SMD) -0.01, 95% CI -0.22 to 0.20; I(2) statistic = 42%; moderate quality evidence). Based on eight studies including 846 participants, we did not find a difference in hospital length of stay (SMD -0.16, 95% CI -0.40 to 0.07; I(2) statistic 52%; moderate quality evidence). A meta-regression showed that the effect size increased proportionally to the peak pressure measured at the end of surgery in the high volume group. We did not find a difference in the risk of pneumothorax (RR 2.01, 95% CI 0.51 to 7.95; I(2) statistic 0%; low quality evidence). Low tidal volumes (defined as < 10 mL/kg) should be used preferentially during surgery. They decrease the need for postoperative ventilatory support (invasive and non-invasive). Further research is required to determine the maximum peak pressure of ventilation that should be allowed during surgery.

Twitter Demographics

The data shown below were collected from the profiles of 8 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 6%
Unknown 16 94%

Demographic breakdown

Readers by professional status Count As %
Researcher 15 88%
Student > Ph. D. Student 12 71%
Student > Master 10 59%
Student > Postgraduate 9 53%
Unspecified 8 47%
Other 18 106%
Readers by discipline Count As %
Medicine and Dentistry 48 282%
Unspecified 12 71%
Nursing and Health Professions 3 18%
Social Sciences 2 12%
Engineering 2 12%
Other 5 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 May 2017.
All research outputs
#2,719,813
of 12,527,219 outputs
Outputs from Cochrane database of systematic reviews
#4,989
of 8,923 outputs
Outputs of similar age
#71,071
of 346,051 outputs
Outputs of similar age from Cochrane database of systematic reviews
#142
of 215 outputs
Altmetric has tracked 12,527,219 research outputs across all sources so far. Compared to these this one has done well and is in the 78th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,923 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.2. This one has gotten more attention than average, scoring higher than 52% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 346,051 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 79% of its contemporaries.
We're also able to compare this research output to 215 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.