{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:23:55Z","timestamp":1787217835685,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004836","name":"Danmarks Frie Forskningsfond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004836","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021817","name":"Knud og Edith Eriksens Mindefond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021817","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010346","name":"Else og Mogens Wedell Wedellsborgs Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010346","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":[[2026,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Optimal ventilatory settings during general anaesthesia are unknown. The goal of this trial was to test different ventilatory settings and blood pressure targets during general anaesthesia. This manuscript focuses on the ventilatory interventions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This was a multicentre, randomised factorial trial conducted at eight hospitals in Denmark. Four hundred and eighty\u2010three patients ASA 3\u20135, scheduled for major surgery under general anaesthesia, were included. Patients were randomised to positive end\u2010expiratory pressure (PEEP) of 5, 8, or 10\u2009cm H\n 2<\/jats:sub>\n O, tidal volume of 6, 8, or 10\u2009mL\/kg, and fraction of inspired oxygen (FiO\n 2<\/jats:sub>\n ) of 30% or 80%. The primary outcome was feasibility of delivering the ventilatory interventions, while secondary outcomes included intra\u2010 and postoperative complications, hospital length of stay, quality of life and recovery, and mortality.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Feasibility goals were not met, but clear separation within each intervention was achieved. There were no differences between groups in most postoperative outcomes. Cardiac arrhythmias appeared more frequently in the PEEP\u20108\u2010 and 10\u2010cm\u2010H\n 2<\/jats:sub>\n O groups (OR 9.32, 95% CI 1.59; 178 and OR 6.71, 95% CI 1.00; 134), compared to the PEEP\u20105\u2010cm\u2010H\n 2<\/jats:sub>\n O group. Outcomes did not differ between tidal volume interventions. Pneumonia (OR 4.04, 95% CI 1.40; 14.6) and emergence delirium (OR 5.56, 95% CI 1.94; 20.4) were more frequent in patients allocated to FiO\n 2<\/jats:sub>\n of 80% than 30%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Adherence to interventions was acceptable, although below feasibility goals. Few postoperative complications were more frequent in patients receiving PEEP 8 and 10, and in patients receiving FiO\n 2<\/jats:sub>\n of 80%. These findings should be interpreted with caution given the uncertainty of the estimates.\n <\/jats:p>\n \n Trial Registration:<\/jats:bold>\n Clinicaltrials.gov: NCT06047119\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/aas.70309","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T01:03:56Z","timestamp":1785200636000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Positive End\u2010Expiratory Pressure, Tidal Volume, and Fraction of Inspired Oxygen During General Anaesthesia in High\u2010Risk Patients\u2014A Randomised Clinical Feasibility Trial"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5318-9941","authenticated-orcid":false,"given":"Maria B.","family":"P\u00e6lestik","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3993-0358","authenticated-orcid":false,"given":"Benjamin H.","family":"Risager","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7947-5110","authenticated-orcid":false,"given":"Signe \u00d8.","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7749-6003","authenticated-orcid":false,"given":"Olav L.","family":"Schj\u00f8rring","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aalborg University Hospital Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6499-9691","authenticated-orcid":false,"given":"Jannie","family":"Bisgaard","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aalborg University Hospital Aalborg Denmark"},{"name":"Department of Clinical Medicine Aalborg University Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0227-6636","authenticated-orcid":false,"given":"Kasper G.","family":"Berthelsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Balsl\u00f8v","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2815-1891","authenticated-orcid":false,"given":"Leif","family":"Bach","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Randers Regional Hospital Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9429-2424","authenticated-orcid":false,"given":"Kim B.","family":"P\u00e6lestik","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Randers Regional Hospital Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen G. R.","family":"Rossau","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Randers Regional Hospital Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Randers Regional Hospital Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2585-4490","authenticated-orcid":false,"given":"Christoffer","family":"S\u00f8lling","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Viborg Regional Hospital Viborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0681-9688","authenticated-orcid":false,"given":"Jannie T.","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Viborg Regional Hospital Viborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"Enevoldsen","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Viborg Regional Hospital Viborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9189-6694","authenticated-orcid":false,"given":"L\u00e6rke D. D.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Operation and Intensive Care Viborg Regional Hospital Viborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine T.","family":"Zwisler","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole M.","family":"Brahe","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders M.","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1354-2818","authenticated-orcid":false,"given":"Ida A.","family":"Guldberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Zealand University Hospital K\u00f8ge Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9261-1463","authenticated-orcid":false,"given":"Maria A.","family":"Joost","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Zealand University Hospital K\u00f8ge Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3533-8098","authenticated-orcid":false,"given":"Henning B.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Zealand University Hospital K\u00f8ge Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3659-650X","authenticated-orcid":false,"given":"Ulrick S.","family":"Espelund","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Horsens Regional Hospital Horsens Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4446-710X","authenticated-orcid":false,"given":"Lone Dragnes","family":"Brix","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Horsens Regional Hospital Horsens Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6174-4527","authenticated-orcid":false,"given":"Jens A. K.","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0536-560X","authenticated-orcid":false,"given":"Christian F.","family":"Eriksen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7734-7607","authenticated-orcid":false,"given":"Anders G.","family":"Kj\u00e6rgaard","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-3442","authenticated-orcid":false,"given":"Pia D.","family":"Dinesen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2396-5639","authenticated-orcid":false,"given":"Malene L.","family":"Abildgren","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aalborg University Hospital Aalborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4582-6538","authenticated-orcid":false,"given":"Mikael F.","family":"Vallentin","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"},{"name":"Prehospital Emergency Medical Services, Central Denmark Region Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9445-7690","authenticated-orcid":false,"given":"Marie K.","family":"Jessen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-1459","authenticated-orcid":false,"given":"Simon T.","family":"Vistisen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1422-3809","authenticated-orcid":false,"given":"Casper H.","family":"N\u00f8rholt","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6677-3750","authenticated-orcid":false,"given":"Cecilie D.","family":"Baltsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9290-4264","authenticated-orcid":false,"given":"Lotte K.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6975-4885","authenticated-orcid":false,"given":"Frederik G.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea W.","family":"Frilund","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofie","family":"Winther","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asger","family":"Granfelt","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5752-8082","authenticated-orcid":false,"given":"Lars W.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus Denmark"},{"name":"Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark"},{"name":"Prehospital Emergency Medical Services, Central Denmark Region Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006106"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.14102"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.70315"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005043421801"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000118"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60416-5"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004342"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000183655.57275.7a"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.12866"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1301082"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2020.110156"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181e19d1d"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000436849.79161.a4"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2020.110009"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.70309","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aas.70309","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.70309","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T08:27:17Z","timestamp":1787214437000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.70309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/aas.70309"],"URL":"https:\/\/doi.org\/10.1111\/aas.70309","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]},"assertion":[{"value":"2026-02-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70309"}}