{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:45:48Z","timestamp":1791474348364,"version":"4.3.4"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T00:00:00Z","timestamp":1670025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T00:00:00Z","timestamp":1670025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Risk factors for postoperative pulmonary complication (PPC) have not been determined according to preoperative respiratory spirometry. Thus, we aimed to find contributors for PPC in patients with restrictive or normal spirometric pattern. We analyzed 654 patients (379 with normal and 275 with restrictive spirometric pattern). PPCs comprised respiratory failure, pleural effusion, atelectasis, respiratory infection, and bronchospasm. We analyzed the association between perioperative factors and PPC using binary logistic regression. In particular, we conducted subgroup analysis on the patients stratified according to preoperative spirometry. Of 654 patients, 27\/379 patients (7.1%) with normal spirometric pattern and 33\/275 patients (12.0%) with restrictive spirometric pattern developed PPCs. Multivariable analysis demonstrated that high driving pressure was the only intraoperative modifiable factor increasing PPC risk (OR\u2009=\u20091.13 [1.02\u20131.25], p\u2009=\u20090.025). In the subgroup of patients with restrictive spirometric pattern, intraoperative driving pressure was significantly associated with PPC (OR\u2009=\u20091.21 [1.05\u20131.39], p\u2009=\u20090.009), whereas driving pressure was not associated with PPC in patients with normal spirometric pattern (OR\u2009=\u20091.04 [0.89\u20131.21], p\u2009=\u20090.639). In patients with restrictive spirometric pattern, greater intraoperative driving pressure is significantly associated with increased PPC risk. In contrast, intraoperative driving pressure is not associated with PPC in patients with normal spirometric pattern.<\/jats:p>","DOI":"10.1038\/s41598-022-24627-2","type":"journal-article","created":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T11:03:08Z","timestamp":1670065388000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The impact of driving pressure on postoperative pulmonary complication in patients with different respiratory spirometry"],"prefix":"10.1038","volume":"12","author":[{"given":"Eun Jung","family":"Oh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Guen","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhee","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangbin","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beomsu","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Hye","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeayoun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dancheong","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Ah","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Yun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,3]]},"reference":[{"key":"24627_CR1","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1093\/bja\/aex002","volume":"118","author":"A Miskovic","year":"2017","unstructured":"Miskovic, A. & Lumb, A. B. Postoperative pulmonary complications. Br. J. Anaesth. 118, 317\u2013334. https:\/\/doi.org\/10.1093\/bja\/aex002 (2017).","journal-title":"Br. J. Anaesth."},{"key":"24627_CR2","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1097\/ALN.0b013e3181fc6e0a","volume":"113","author":"J Canet","year":"2010","unstructured":"Canet, J. et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology 113, 1338\u20131350. https:\/\/doi.org\/10.1097\/ALN.0b013e3181fc6e0a (2010).","journal-title":"Anesthesiology"},{"key":"24627_CR3","doi-asserted-by":"publisher","first-page":"1599","DOI":"10.1378\/chest.12-1499","volume":"143","author":"H Gupta","year":"2013","unstructured":"Gupta, H. et al. Impact of COPD on postoperative outcomes: Results from a national database. Chest 143, 1599\u20131606. https:\/\/doi.org\/10.1378\/chest.12-1499 (2013).","journal-title":"Chest"},{"key":"24627_CR4","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1111\/resp.12988","volume":"22","author":"B Shin","year":"2017","unstructured":"Shin, B. et al. Airflow limitation severity and post-operative pulmonary complications following extra-pulmonary surgery in COPD patients. Respirology 22, 935\u2013941. https:\/\/doi.org\/10.1111\/resp.12988 (2017).","journal-title":"Respirology"},{"key":"24627_CR5","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.bpa.2015.08.002","volume":"29","author":"TA Treschan","year":"2015","unstructured":"Treschan, T. A., Malbouisson, L. M. & Beiderlinden, M. Intraoperative mechanical ventilation strategies to prevent postoperative pulmonary complications in patients with pulmonary and extrapulmonary comorbidities. Best Pract. Res. Clin. Anaesthesiol. 29, 341\u2013355. https:\/\/doi.org\/10.1016\/j.bpa.2015.08.002 (2015).","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"24627_CR6","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1097\/01.ccm.0000168044.98844.30","volume":"33","author":"MP Caramez","year":"2005","unstructured":"Caramez, M. P. et al. Paradoxical responses to positive end-expiratory pressure in patients with airway obstruction during controlled ventilation. Crit. Care Med. 33, 1519\u20131528. https:\/\/doi.org\/10.1097\/01.ccm.0000168044.98844.30 (2005).","journal-title":"Crit. Care Med."},{"key":"24627_CR7","doi-asserted-by":"publisher","first-page":"2505","DOI":"10.3748\/wjg.v12.i16.2505","volume":"12","author":"WJ Jiao","year":"2006","unstructured":"Jiao, W. J. et al. Pulmonary complications in patients with chronic obstructive pulmonary disease following transthoracic esophagectomy. World J. Gastroenterol. 12, 2505\u20132509. https:\/\/doi.org\/10.3748\/wjg.v12.i16.2505 (2006).","journal-title":"World J. Gastroenterol."},{"key":"24627_CR8","doi-asserted-by":"publisher","first-page":"12750","DOI":"10.1038\/s41598-019-49158-1","volume":"9","author":"SH Shin","year":"2019","unstructured":"Shin, S. H. et al. Restrictive spirometric pattern and postoperative pulmonary complications following non-cardiothoracic surgery. Sci. Rep. 9, 12750. https:\/\/doi.org\/10.1038\/s41598-019-49158-1 (2019).","journal-title":"Sci. Rep."},{"key":"24627_CR9","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/s0954-6111(96)90241-3","volume":"90","author":"A Kocabas","year":"1996","unstructured":"Kocabas, A., Kara, K., Ozgur, G., Sonmez, H. & Burgut, R. Value of preoperative spirometry to predict postoperative pulmonary complications. Respir. Med. 90, 25\u201333. https:\/\/doi.org\/10.1016\/s0954-6111(96)90241-3 (1996).","journal-title":"Respir. Med."},{"key":"24627_CR10","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1183\/09031936.97.10061301","volume":"10","author":"G Barisione","year":"1997","unstructured":"Barisione, G., Rovida, S., Gazzaniga, G. M. & Fontana, L. Upper abdominal surgery: Does a lung function test exist to predict early severe postoperative respiratory complications?. Eur. Respir. J. 10, 1301 (1997).","journal-title":"Eur. Respir. J."},{"key":"24627_CR11","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/s0002-9343(01)01082-8","volume":"112","author":"BW Fisher","year":"2002","unstructured":"Fisher, B. W., Majumdar, S. R. & McAlister, F. A. Predicting pulmonary complications after nonthoracic surgery: A systematic review of blinded studies. Am. J. Med. 112, 219\u2013225. https:\/\/doi.org\/10.1016\/s0002-9343(01)01082-8 (2002).","journal-title":"Am. J. Med."},{"key":"24627_CR12","doi-asserted-by":"publisher","first-page":"150","DOI":"10.3390\/jcm9010150","volume":"9","author":"S Park","year":"2020","unstructured":"Park, S. et al. Intraoperative anesthetic management of patients with chronic obstructive pulmonary disease to decrease the risk of postoperative pulmonary complications after abdominal surgery. J. Clin. Med. 9, 150. https:\/\/doi.org\/10.3390\/jcm9010150 (2020).","journal-title":"J. Clin. Med."},{"key":"24627_CR13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0113656","volume":"9","author":"BH Jeong","year":"2014","unstructured":"Jeong, B. H. et al. Development of a prediction rule for estimating postoperative pulmonary complications. PLoS\u00a0One 9, e113656. https:\/\/doi.org\/10.1371\/journal.pone.0113656 (2014).","journal-title":"PLoS\u00a0One"},{"key":"24627_CR14","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1183\/09031936.05.00034805","volume":"26","author":"MR Miller","year":"2005","unstructured":"Miller, M. R. et al. Standardisation of spirometry. Eur. Respir. J. 26, 319\u2013338. https:\/\/doi.org\/10.1183\/09031936.05.00034805 (2005).","journal-title":"Eur. Respir. J."},{"key":"24627_CR15","doi-asserted-by":"publisher","first-page":"230","DOI":"10.4046\/trd.2005.58.3.230","volume":"58","author":"JK Choi","year":"2005","unstructured":"Choi, J. K., Paek, D. & Lee, J. O. Normal predictive values of spirometry in Korean population. Tuberc. Respir. Dis. 58, 230\u2013242 (2005).","journal-title":"Tuberc. Respir. Dis."},{"key":"24627_CR16","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1378\/chest.15-1045","volume":"149","author":"MS Godfrey","year":"2016","unstructured":"Godfrey, M. S. & Jankowich, M. D. The vital capacity is vital: Epidemiology and clinical significance of the restrictive spirometry pattern. Chest 149, 238\u2013251. https:\/\/doi.org\/10.1378\/chest.15-1045 (2016).","journal-title":"Chest"},{"key":"24627_CR17","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1111\/tri.12895","volume":"30","author":"G Heinze","year":"2017","unstructured":"Heinze, G. & Dunkler, D. Five myths about variable selection. Transpl. Int. 30, 6\u201310. https:\/\/doi.org\/10.1111\/tri.12895 (2017).","journal-title":"Transpl. Int."},{"key":"24627_CR18","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1056\/NEJMoa1301082","volume":"369","author":"E Futier","year":"2013","unstructured":"Futier, E. et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery. N. Engl. J. Med. 369, 428\u2013437. https:\/\/doi.org\/10.1056\/NEJMoa1301082 (2013).","journal-title":"N. Engl. J. Med."},{"key":"24627_CR19","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1097\/SLA.0000000000001443","volume":"263","author":"D Yang","year":"2016","unstructured":"Yang, D., Grant, M. C., Stone, A., Wu, C. L. & Wick, E. C. A Meta-analysis of intraoperative ventilation strategies to prevent pulmonary complications: Is low tidal volume alone sufficient to protect healthy lungs?. Ann. Surg. 263, 881\u2013887. https:\/\/doi.org\/10.1097\/SLA.0000000000001443 (2016).","journal-title":"Ann. Surg."},{"key":"24627_CR20","doi-asserted-by":"publisher","first-page":"2136","DOI":"10.1007\/s11605-011-1719-z","volume":"15","author":"HJ Bae","year":"2011","unstructured":"Bae, H. J. et al. Prealbumin levels as a useful marker for predicting infectious complications after gastric surgery. J. Gastrointest. Surg. 15, 2136\u20132144. https:\/\/doi.org\/10.1007\/s11605-011-1719-z (2011).","journal-title":"J. Gastrointest. Surg."},{"key":"24627_CR21","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1097\/aln.0000000000002731","volume":"131","author":"EC Williams","year":"2019","unstructured":"Williams, E. C., Motta-Ribeiro, G. C. & Vidal Melo, M. F. Driving pressure and transpulmonary pressure: How do we guide safe mechanical ventilation?. Anesthesiology 131, 155\u2013163. https:\/\/doi.org\/10.1097\/aln.0000000000002731 (2019).","journal-title":"Anesthesiology"},{"key":"24627_CR22","doi-asserted-by":"publisher","first-page":"1452","DOI":"10.1164\/rccm.201512-2448CP","volume":"194","author":"SH Loring","year":"2016","unstructured":"Loring, S. H., Topulos, G. P. & Hubmayr, R. D. Transpulmonary pressure: The importance of precise definitions and limiting assumptions. Am. J. Respir. Crit. Care Med. 194, 1452\u20131457. https:\/\/doi.org\/10.1164\/rccm.201512-2448CP (2016).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"24627_CR23","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/S2213-2600(16)00057-6","volume":"4","author":"AS Neto","year":"2016","unstructured":"Neto, A. S. et al. Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: A meta-analysis of individual patient data. Lancet Respir. Med. 4, 272\u2013280. https:\/\/doi.org\/10.1016\/S2213-2600(16)00057-6 (2016).","journal-title":"Lancet Respir. Med."},{"issue":"95","key":"24627_CR24","doi-asserted-by":"publisher","first-page":"1542","DOI":"10.1152\/japplphysiol.01010.2002","volume":"1985","author":"F Garc\u00eda-R\u00edo","year":"2003","unstructured":"Garc\u00eda-R\u00edo, F. et al. Accuracy of noninvasive estimates of respiratory muscle effort during spontaneous breathing in restrictive diseases. J. Appl. Physiol. 1985(95), 1542\u20131549. https:\/\/doi.org\/10.1152\/japplphysiol.01010.2002 (2003).","journal-title":"J. Appl. Physiol."},{"key":"24627_CR25","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1007\/s00134-005-2627-z","volume":"31","author":"L Gattinoni","year":"2005","unstructured":"Gattinoni, L. & Pesenti, A. The concept of \u201cbaby lung\u201d. Intensive Care Med. 31, 776\u2013784. https:\/\/doi.org\/10.1007\/s00134-005-2627-z (2005).","journal-title":"Intensive Care Med."},{"key":"24627_CR26","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1056\/NEJMsa1410639","volume":"372","author":"MB Amato","year":"2015","unstructured":"Amato, M. B. et al. Driving pressure and survival in the acute respiratory distress syndrome. N. Engl. J. Med. 372, 747\u2013755. https:\/\/doi.org\/10.1056\/NEJMsa1410639 (2015).","journal-title":"N. Engl. J. Med."},{"key":"24627_CR27","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1186\/s13054-016-1556-2","volume":"20","author":"C Guerin","year":"2016","unstructured":"Guerin, C. et al. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials. Crit. Care 20, 384. https:\/\/doi.org\/10.1186\/s13054-016-1556-2 (2016).","journal-title":"Crit. Care"},{"key":"24627_CR28","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1097\/aln.0000000000002600","volume":"130","author":"M Park","year":"2019","unstructured":"Park, M. et al. Driving pressure during thoracic surgery: A randomized clinical trial. Anesthesiology 130, 385\u2013393. https:\/\/doi.org\/10.1097\/aln.0000000000002600 (2019).","journal-title":"Anesthesiology"},{"key":"24627_CR29","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1183\/1025448x.00043010","volume-title":"Respiratory Diseases in the Elderly","author":"RC Stansbury","year":"2009","unstructured":"Stansbury, R. C. & Mannino, D. M. In Respiratory Diseases in the Elderly (eds Bellia, V. & Antonelli Incalzi, R.) 142\u2013149 (European Respiratory Society Journals, 2009)."},{"key":"24627_CR30","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1164\/arrd.1985.132.6.1210","volume":"132","author":"NK Burki","year":"1985","unstructured":"Burki, N. K. Detection of added respiratory loads in patients with restrictive lung disease. Am. Rev. Respir. Dis. 132, 1210\u20131213. https:\/\/doi.org\/10.1164\/arrd.1985.132.6.1210 (1985).","journal-title":"Am. Rev. Respir. Dis."},{"key":"24627_CR31","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/cc12528","volume":"17","author":"GA Cortes","year":"2013","unstructured":"Cortes, G. A. & Marini, J. J. Two steps forward in bedside monitoring of lung mechanics: Transpulmonary pressure and lung volume. Crit. Care 17, 219. https:\/\/doi.org\/10.1186\/cc12528 (2013).","journal-title":"Crit. Care"},{"key":"24627_CR32","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/j.bja.2020.08.058","volume":"126","author":"Assessment of Ventilation during general AnesThesia for Robotic surgery (AVATaR) Study Investigators, PROtectiveVEntilation (PROVE) Network, Writing Committee Members, Steering Committee Members and AVATaR Investigators","year":"2021","unstructured":"Assessment of Ventilation during general AnesThesia for Robotic surgery (AVATaR) Study Investigators, PROtectiveVEntilation (PROVE) Network, Writing Committee Members, Steering Committee Members and AVATaR Investigators. Ventilation and outcomes following robotic-assisted abdominal surgery: An international, multicentre observational study. Br. J. Anaesth. 126, 533\u2013543. https:\/\/doi.org\/10.1016\/j.bja.2020.08.058 (2021).","journal-title":"Br. J. Anaesth."},{"key":"24627_CR33","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1513\/pats.200508-094DO","volume":"3","author":"GT Ferguson","year":"2006","unstructured":"Ferguson, G. T. Why does the lung hyperinflate?. Proc. Am. Thorac. Soc. 3, 176\u2013179. https:\/\/doi.org\/10.1513\/pats.200508-094DO (2006).","journal-title":"Proc. Am. Thorac. Soc."},{"key":"24627_CR34","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1164\/ajrccm.156.4.97-01052","volume":"156","author":"VM Ranieri","year":"1997","unstructured":"Ranieri, V. M. et al. Impairment of lung and chest wall mechanics in patients with acute respiratory distress syndrome: Role of abdominal distension. Am. J. Respir. Crit. Care Med. 156, 1082\u20131091. https:\/\/doi.org\/10.1164\/ajrccm.156.4.97-01052 (1997).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"24627_CR35","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1164\/rccm.201709-1806OC","volume":"197","author":"T Yoshida","year":"2018","unstructured":"Yoshida, T. et al. Esophageal manometry and regional transpulmonary pressure in lung injury. Am. J. Respir. Crit. Care Med. 197, 1018\u20131026. https:\/\/doi.org\/10.1164\/rccm.201709-1806OC (2018).","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"24627_CR36","unstructured":"Global Initiative for Chronic Obstructive Lung Disease. Spirometry for Health Care Providers. Global Initiative for Chronic Obstructive Lung Disease (GOLD). http:\/\/www.gpcme.co.nz\/pdf\/GOLD%20SpirometryFull%5B1%5D.pdf."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-24627-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-24627-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-24627-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T21:16:14Z","timestamp":1670361374000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-022-24627-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,3]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["24627"],"URL":"https:\/\/doi.org\/10.1038\/s41598-022-24627-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,3]]},"assertion":[{"value":"26 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20875"}}