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Maintaining ventilation with very low tidal volume and positive-end expiratory pressure versus no ventilation during cardiopulmonary bypass for cardiac surgery in adults: a randomized clinical trial

dc.rights.licenseopenen_US
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierMicroenvironment and B-cells: Immunopathology,Cell Differentiation, and Cancer [MOBIDIC]
hal.structure.identifierCentre d'Investigation Clinique [Rennes] [CIC]
dc.contributor.authorTADIE, Jean-Marc
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorOUATTARA, Alexandre
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierInstitut de recherche en santé, environnement et travail [Irset]
hal.structure.identifierCentre d'Investigation Clinique [Rennes] [CIC]
dc.contributor.authorLAVIOLLE, Bruno
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierMicroenvironment and B-cells: Immunopathology,Cell Differentiation, and Cancer [MOBIDIC]
hal.structure.identifierCentre d'Investigation Clinique [Rennes] [CIC]
dc.contributor.authorLESOUHAITIER, Mathieu
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierCentre d'Investigation Clinique [Rennes] [CIC]
dc.contributor.authorESVAN, Maxime
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierCentre d'Investigation Clinique [Rennes] [CIC]
dc.contributor.authorROUSSEAU, Chloe
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierMicroenvironment and B-cells: Immunopathology,Cell Differentiation, and Cancer [MOBIDIC]
dc.contributor.authorGRÉGOIRE, Murielle
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
dc.contributor.authorGAUDRIOT, Baptiste
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierNutrition, Métabolismes et Cancer [NuMeCan]
dc.contributor.authorNESSELER, Nicolas
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
dc.contributor.authorLABASTE, François
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
dc.contributor.authorSANCHEZ, Pascale
hal.structure.identifierCentre Hospitalier Universitaire de Toulouse [CHU Toulouse]
dc.contributor.authorMARCHEIX, Bertrand
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorBEURTON, Antoine
hal.structure.identifierCHU Pitié-Salpêtrière [AP-HP]
hal.structure.identifierAssistance publique - Hôpitaux de Paris (AP-HP) [AP-HP]
hal.structure.identifierGroupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE]
dc.contributor.authorDUREAU, Pauline
hal.structure.identifierAssistance publique - Hôpitaux de Paris (AP-HP) [AP-HP]
hal.structure.identifierCHU Pitié-Salpêtrière [AP-HP]
dc.contributor.authorDEMONDION, Pierre
hal.structure.identifierCentre Hospitalier Universitaire d'Angers [CHU Angers]
dc.contributor.authorFOUQUET, Olivier
hal.structure.identifierCentre Hospitalier Universitaire d'Angers [CHU Angers]
dc.contributor.authorRINEAU, Emmanuel
hal.structure.identifierHôpital Privé Jacques Cartier [Massy]
dc.contributor.authorAMOUR, Julien
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierLaboratoire Traitement du Signal et de l'Image [LTSI]
dc.contributor.authorVERHOYE, Jean-Philippe
dc.contributor.authorMERCAT, Alain
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierCentre d'Investigation Clinique [Rennes] [CIC]
dc.contributor.authorTERZI, Nicolas
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierMicroenvironment and B-cells: Immunopathology,Cell Differentiation, and Cancer [MOBIDIC]
dc.contributor.authorTARTE, Karin
hal.structure.identifierCHU Pitié-Salpêtrière [AP-HP]
hal.structure.identifierAssistance publique - Hôpitaux de Paris (AP-HP) [AP-HP]
hal.structure.identifierGroupe de Recherche Clinique en Anesthésie Réanimation médecine PEriopératoire [GRC 29 - ARPE]
dc.contributor.authorBOUGLÉ, Adrien
hal.structure.identifierCentre Hospitalier Universitaire [Rennes]
hal.structure.identifierLaboratoire Traitement du Signal et de l'Image [LTSI]
dc.contributor.authorFLÉCHER, Erwan
dc.date.accessioned2025-05-15T07:09:20Z
dc.date.available2025-05-15T07:09:20Z
dc.date.issued2025
dc.identifier.issn0342-4642en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/206626
dc.description.abstractEnPurpose: Cardiopulmonary bypass (CPB) during cardiac surgery mechanically circulates and oxygenates the blood, bypassing the heart and lungs. Despite limited evidence, maintaining mechanical ventilation (MV) during CPB is recommended, as ventilator strategies during surgery may reduce the occurrence of postoperative infections. We aimed to determine whether maintaining MV for cardiac surgery would decrease postoperative infections compared with stopping MV during CPB.Methods: We conducted a multicenter, single-blind, randomized trial among adult patients undergoing scheduled cardiac surgery with CPB in six hospitals in France. During CPB, the tracheal tube was disconnected from the ventilator in the control group (MV- group). In the MV + group, ventilation was maintained during CPB with very low tidal volume ventilation, using a tidal volume of 2.5 mL/kg of predicted body weight, with 5-7 cmH2O positive end expiratory pressure. The primary outcome was the occurrence of all types of postoperative infections within the first 28 days after surgery. There were six secondary evaluation criteria including the number of days of exposure to antibiotics.Results: A total of 1362 patients were enrolled in the study. Postoperative infection occurred in 74 out of 680 patients (10.9%) in the MV- group, compared to 68 out of 682 patients (10.0%) in the MV + group (relative risk, 0.92; 95% confidence interval [CI] 0.67-1.25; p = 0.58). Antibiotic use was higher in the MV + group than in the MV- group (incidence risk ratio, 1.08; 95% CI 1.02-1.15; p = 0.02). There were no significant differences between the groups for all other secondary outcomes or for the incidence of adverse events.Conclusions: Maintaining very low tidal volume ventilation with positive end-expiratory pressure during CPB did not reduce postoperative infections at 28 days compared to when mechanical ventilation was stopped during CPB. An unexpectedly higher use of antibiotics was observed when ventilation was maintained.Trial registration: ClinicalTrials.gov (NCT03372174)
dc.language.isoENen_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc/
dc.subject.enCardiac surgery
dc.subject.enCardiopulmonary bypass
dc.subject.enMechanical ventilation
dc.subject.enPostoperative infection
dc.title.enMaintaining ventilation with very low tidal volume and positive-end expiratory pressure versus no ventilation during cardiopulmonary bypass for cardiac surgery in adults: a randomized clinical trial
dc.typeArticle de revueen_US
dc.identifier.doi10.1007/s00134-025-07901-5en_US
dc.subject.halSciences du Vivant [q-bio]en_US
dc.identifier.pubmed40323450en_US
bordeaux.journalIntensive Care Medicineen_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires (BMC) - UMR 1034en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcehal
hal.identifierhal-05066745
hal.version1
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
workflow.import.sourcehal
dc.rights.ccPas de Licence CCen_US
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