A Trial of Intraoperative Low-Tidal-Volume Ventilation in Abdominal Surgery

In this multi-institutional prospective trial, 400 pts at increased risk for pulmonary complications after major abdominal surgery were randomized to standard intraoperative ventilator management and lung-protective management with low tidal volumes and PEEP.  A composite of pulmonary and extrapulmonary complications occurred in 27.5% of the control group compared to 10.5% of the treatment group at 7 days.  The incidence of respiratory failure was 17% in the control group and 5% in the treatment group.   The treatment group length of stay was 2.5 days shorter.