Intraoperative low tidal volume ventilation and the risk of ICD-10 coded delirium and the use for antipsychotic medications

Bibliographic Details
Title: Intraoperative low tidal volume ventilation and the risk of ICD-10 coded delirium and the use for antipsychotic medications
Authors: Dharshi Karalapillai, Laurence Weinberg, Ary Serpa Neto, Philip J. Peyton, Louise Ellard, Raymond Hu, Brett Pearce, Chong Tan, David Story, Mark O’Donnell, Patrick Hamilton, Chad Oughton, Jonathan Galtieri, Sree Appu, Anthony Wilson, Glenn Eastwood, Rinaldo Bellomo, Daryl A. Jones
Source: BMC Anesthesiology, Vol 22, Iss 1, Pp 1-9 (2022)
Publisher Information: BMC, 2022.
Publication Year: 2022
Collection: LCC:Anesthesiology
Subject Terms: Delirium, Postoperative, Surgery, Tidal volume, Anesthesiology, RD78.3-87.3
More Details: Abstract Background Low tidal volume (VT) ventilation and its associated increase in arterial carbon dioxide (PaCO2) may affect postoperative neurologic function. We aimed to test the hypothesis that intraoperative low VT ventilation affect the incidence of postoperative ICD-10 coded delirium and/or the need for antipsychotic medications. Methods This is a post-hoc analysis of a large randomized controlled trial evaluating low vs. conventional VT ventilation during major non-cardiothoracic, non-intracranial surgery. The primary outcome was the incidence of ICD-10 delirium and/or the use of antipsychotic medications during hospital stay, and the absolute difference with its 95% confidence interval (CI) was calculated. Results We studied 1206 patients (median age of 64 [55–72] years, 59.0% males, median ARISCAT of 26 [19–37], and 47.6% of ASA 3). ICD-10 coded delirium and /or antipsychotic medication use was diagnosed in 11.2% with similar incidence between low and conventional VT ventilation (11.1% vs. 11.3%; absolute difference, -0.24 [95%CI, -3.82 to 3.32]; p = 0.894). There was no interaction between allocation group and type of surgery. Conclusion In adult patients undergoing major surgery, low VT ventilation was not associated with increased risk of ICD-10 delirium and/or the use of antipsychotic medications during hospital stay. Trial registration ANZCTR Identifier: ACTRN12614000790640 .
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2253
Relation: https://doaj.org/toc/1471-2253
DOI: 10.1186/s12871-022-01689-3
Access URL: https://doaj.org/article/030986c63abb4516abe43296236207e5
Accession Number: edsdoj.030986c63abb4516abe43296236207e5
Database: Directory of Open Access Journals
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ISSN:14712253
DOI:10.1186/s12871-022-01689-3
Published in:BMC Anesthesiology
Language:English