Characterizing ventilatory management practices in patients under general anesthesia at the Hospital de Clínicas of National University of Asuncion

Abstract

Introduction: Mechanical ventilation is an essential requirement during general anesthesia to ensure adequate oxygenation of intubated patients. There are vital competencies to anesthesiologists that are required to guarantee appropriate ventilatory management.

Objective: To assess the application of protective ventilation parameters by anesthesiologists in routine practice. Methodology: This observational, descriptive, cross-sectional study conducted in September 2021, included 62 specialist physicians and residents in Anesthesiology and Resuscitation. Non – probabilistic consecutive sampling was employed, and data were collected using a modified version of the VENTILOP questionnaire. Variables, such as years of professional experience and ventilatory parameters, were analyzed. Results: A total of 62 professionals were analyzed. It was observed that 95,2% of them used tidal volume ranging from 6 – 8 ml/kg, with 88,7% calculating this volume based on ideal body weight. Systematic adjustment of the I:E ratio was reported by 64.5% of the participants. Furthermore 66,1 % used an FiO₂ lower than 50% in the absence of hypoxemia. Regarding the application of positive end-expiratory pressure (PEEP), 78.7% always used PEEP > 5 cmH2O, and 75.8% employ alveolar recruitment maneuvers during mechanical ventilation. Conclusion: Half of the respondents reported carrying out their practice with parameters consistent with protective mechanical ventilation, indicating a significant improvement in ventilatory management compared to previous studies. This study highlights crucial points that will facilitate the development of strategies aimed at optimizing implementation of appropriate protective mechanical ventilation, leading to a reduction in postoperative respiratory complications.