{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:19:41Z","timestamp":1787908781326,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T00:00:00Z","timestamp":1632268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T00:00:00Z","timestamp":1632268800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007542","name":"Air Liquide","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011924","name":"European Society of Anaesthesiology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011924","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI14\/00829"],"award-info":[{"award-number":["PI14\/00829"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The preventive role of an intraoperative recruitment maneuver plus open lung approach (RM\u00a0+\u00a0OLA) ventilation on postoperative pulmonary complications (PPC) remains unclear. We aimed at investigating whether an intraoperative open lung condition reduces the risk of developing a composite of PPCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Post hoc analysis of two randomized controlled trials including patients undergoing abdominal surgery. Patients were classified according to the intraoperative lung condition as \u201copen\u201d (OL) or \u201cnon\u2010open\u201d (NOL) if PaO\n                      <jats:sub>2<\/jats:sub>\n                      \/FIO\n                      <jats:sub>2<\/jats:sub>\n                      ratio was \u2265 or &lt;400\u00a0mmHg, respectively. We used a multivariable logistic regression model that included potential confounders selected with directed acyclic graphs (DAG) using Dagitty software built with variables that were considered clinically relevant based on biological mechanism or evidence from previously published data. PPCs included severe acute respiratory failure, acute respiratory distress syndrome, and pneumonia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1480 patients were included in the final analysis, with 718 (49%) classified as OL. The rate of severe PPCs during the first seven postoperative days was 6.0% (7.9% in the NOL and 4.4% in the OL group,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.007). OL was independently associated with a lower risk for severe PPCs during the first 7 and 30 postoperative days [odds ratio of 0.58 (95% CI 0.34\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.04) and 0.56 (95% CI 0.34\u20130.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.03), respectively].\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An intraoperative open lung condition was associated with a reduced risk of developing severe PPCs in intermediate\u2010to\u2010high risk patients undergoing abdominal surgery.<\/jats:p>\n                    <jats:p>Trial registration: Registered at clinicaltrials.gov NCT02158923 (iPROVE), NCT02776046 (iPROVE\u2010O2).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.13979","type":"journal-article","created":{"date-parts":[[2021,8,30]],"date-time":"2021-08-30T14:34:53Z","timestamp":1630334093000},"page":"30-39","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Intraoperative open lung condition and postoperative pulmonary complications. A secondary analysis of iPROVE and iPROVE\u2010O2 trials"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1907-5323","authenticated-orcid":false,"given":"Carlos","family":"Ferrando","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Hospital Cl\u00ednic Institut D'investigaci\u00f3 August Pi i Sunyer  Barcelona Spain"},{"name":"CIBER de Enfermedades Respiratorias Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Librero","sequence":"additional","affiliation":[{"name":"Navarrabiomed Complejo Hospitalario de Navarra UPNA REDISSEC (Red de Investigaci\u00f3n en Servicios de Salud)  La Palma de Cervell\u00f3 Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Tusman","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Hospital Privado de Comunidad  Mar de Plata Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ary","family":"Serpa\u2010Neto","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care\u2010Research Centre (ANZIC\u2010RC) Monash University  Melbourne Vic. Australia"},{"name":"Department of Critical Care Medicine Hospital Israelita Albert Einstein  Sao Paulo Brazil"},{"name":"Department of Critical Care Melbourne Medical School University of Melbourne Austin Hospital  Melbourne Vic. Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Villar","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias Instituto de Salud Carlos III  Madrid Spain"},{"name":"Multidisciplinary Organ Dysfunction Evaluation Research Network Research Unit Hospital Universitario Dr. Negr\u00edn  Las Palmas de Gran Canaria Spain"},{"name":"Keenan Research Center for Biomedical Science at the Li Ka Shing Knowledge Institute St. Michael\u2019s Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco J.","family":"Belda","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Hospital Israelita Albert Einstein  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Costa","sequence":"additional","affiliation":[{"name":"Cardio\u2010Pulmonary Department Pulmonary Division Heart Institute (Incor) University of S\u00e3o Paulo  Sao Paulo Brazil"},{"name":"Research and Education Institute Hospital Sirio\u2010Liban\u00eas  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo B. P.","family":"Amato","sequence":"additional","affiliation":[{"name":"Cardio\u2010Pulmonary Department Pulmonary Division Heart Institute (Incor) University of S\u00e3o Paulo  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Suarez\u2010Sipmann","sequence":"additional","affiliation":[{"name":"CIBER de Enfermedades Respiratorias Instituto de Salud Carlos III  Madrid Spain"},{"name":"Department of Surgical Sciences Hedenstierna Laboratory Uppsala University Hospital  Uppsala Sweden"},{"name":"Department of Intensive Care Hospital Universitario La Princesa  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the iPROVE Network Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000754"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208707"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000161"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60416-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301082"},{"key":"e_1_2_8_7_1","first-page":"193","article-title":"Individualized PeRioperative Open\u2010lung VEntilation (iPROVE) Network. 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