{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:35:18Z","timestamp":1788330918139,"version":"build-2803163510"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Mechanical power (MP) is the energy transferred to the respiratory system and the lung during mechanical ventilation. The interaction between the anatomical and physiological characteristics of the lung parenchyma and the MP transferred to it during ventilation determines the extent of lung injury. This study aims to assess the association between MP and the development of postoperative pulmonary complications (PPCs) within the first seven postoperative days in adult patients receiving mechanical ventilation during major abdominal onco-surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>After obtaining approval from the institutional ethics committee, written informed consent was obtained from all participants. Patients aged 18\u201380 years undergoing major abdominal onco-surgery under general anaesthesia with mechanical ventilation for more than 3 hours were included in the study. Intraoperative ventilatory parameters were recorded. Predictors for the development of respiratory complications during the first seven days postoperatively were analysed using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The cut-off value for intraoperative MP obtained from the receiver operator curve [area under the curve: (AUC)=0.927;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.01; 95% confidence interval (CI)=0.89,0.97] was 9.5 J\/min with a sensitivity of 87% and specificity of 83%. MP was found to have a statistically significant association with postoperative respiratory failure, with an odds ratio (OR) of 3.22. For each 1-J\/min rise in intraoperative MP, the risk of developing respiratory failure postoperatively increases by 3.2 times. MP of ventilation was found to have an independent association with the development of postoperative RF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study explored the relationship between MP applied to the lungs intraoperatively and the development of RF postoperatively. Our findings suggest that intraoperative MP is a strong, independent predictor of postoperative respiratory failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_239_25","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T16:00:26Z","timestamp":1763481626000},"page":"1368-1375","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Association of intraoperative mechanical power of ventilation with occurrence of postoperative respiratory failure in patients undergoing major abdominal onco-surgery in a tertiary cancer centre - A prospective analytical study"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-9665","authenticated-orcid":false,"given":"Joona","family":"Prabhakaran","sequence":"first","affiliation":[{"name":"Associate Professor, Department of Oncoanaesthesiology, Malabar Cancer Centre (Postgraduate Institute of Oncology Sciences and Research), Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6135-9485","authenticated-orcid":false,"given":"Jashma","family":"Chanduveettil","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Oncoanaesthesiology, Malabar Cancer Centre (Postgraduate Institute of Oncology Sciences and Research), Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8008-6953","authenticated-orcid":false,"given":"Mohandoss","family":"Murugesan","sequence":"additional","affiliation":[{"name":"Additional Professor, Department of Transfusion Medicine, Malabar Cancer Centre (Postgraduate Institute of Oncology Sciences and Research), Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1531-9519","authenticated-orcid":false,"given":"Sairu","family":"Philip","sequence":"additional","affiliation":[{"name":"Professor, Department of Community Medicine, Government Medical College, Pariyaram, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2398-6418","authenticated-orcid":false,"given":"Karthickeyan","family":"Duraisamy","sequence":"additional","affiliation":[{"name":"Founder and Chair, Academy for Public Health, Kozhikode, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2203-9419","authenticated-orcid":false,"given":"Kalpita","family":"Shringarpure","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Preventive and Social Medicine, Medical College Baroda, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/S0140-6736(18)33139-8","article-title":"Correspondence Global burden of postoperative death","volume":"393","author":"Nepogodiev","year":"2019","journal-title":"Lancet"},{"key":"R2-20260420","first-page":"399","article-title":"Intraoperative mechanical power and postoperative pulmonary complications in non-cardiothoracic elective surgery patients: a ten-year retrospective cohort-study","volume":"3","author":"Elefterion","year":"2023","journal-title":"Anesthesiology"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1097\/CCM.0b013e31827417a6","article-title":"Lung stress and strain during mechanical ventilation: Any difference between statics and dynamics?","volume":"41","author":"Protti","year":"2013","journal-title":"Crit Care Med"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1097\/ALN.0000000000001056","article-title":"Mechanical power and development of ventilator-induced lung injury","volume":"124","author":"Cressoni","year":"2016","journal-title":"Anesthesiology"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1007\/s00134-018-5375-6","article-title":"Mechanical power of ventilation is associated with mortality in critically ill patients : an analysis of patients in two observational cohorts","volume":"44","author":"Neto","year":"2018","journal-title":"Intensive Care Med"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00134-016-4505-2","article-title":"Ventilator - 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