15 September 2025 : Clinical Research
Optimizing Ventilation Strategies to Reduce Pulmonary Complications in Frail Patients: A Comparative Study
Yang Cao AEG 1,2, Enci Liu CD 3, Yongling Xu AD 1, Changzheng Shangguan F 4, Mengxia Ge B 1, Changzheng Yuan AB 1, Baohui Xia A 1, Bo Zhang D 1, Di Gao B 1, Wangning Shangguan AE 2*, Juan Chen E 5DOI: 10.12659/MSM.948977
Med Sci Monit 2025; 31:e948977
Table 1 Baseline characteristics of the 2 groups.
| Variable | ΔP group (n=31) | N group (n=30) | t/χ2-value | P value** |
|---|---|---|---|---|
| Sex (Male/Female), n (%) | 16/15 | 16/14 | 0.13 | 0.895 |
| Age (years), mean±SD | 78±5 | 76±7 | 1.22 | 0.228 |
| ASA classification, n (%) | 1.99 | 0.158 | ||
| I | 0.0% (0) | 0.0% (0) | ||
| II | 41.9% (13) | 60.0% (18) | ||
| III | 58.1% (18) | 40.0% (12) | ||
| Frailty severity level, n (%)*** | 0.06 | 0.970 | ||
| Mild (EFS 5–6) | 19.4% (6) | 20.0% (6) | ||
| Moderate (EFS 7–8) | 58.1% (18) | 60.0% (18) | ||
| Severe (EFS ≥9) | 22.6% (7) | 20.0% (6) | ||
| BMI (kg/m), mean±SD | 23.7±4.0 | 23.2±4.2 | 0.51 | 0.614 |
| Weight (kg), mean±SD | 63.3±13.0 | 59.4±10.2 | 1.29 | 0.201 |
| Ideal body weight (kg), mean±SD | 56.0±9.0 | 56.3±7.5 | −0.11 | 0.910 |
| Preoperative pulmonary disease, n (%)**** | 54.8% (17) | 73.3% (22) | 2.26 | 0.133 |
| COPD | 3.2% (1) | 0.0% (0) | ||
| Asthma | 6.5% (2) | 0.0% (0) | ||
| ILD | 3.2% (1) | 3.3% (1) | ||
| Others | 41.9% (13) | 70.0% (21) | ||
| Surgical type, n (%)***** | 1.61 | 0.952 | ||
| Laparoscopic surgery | 54.9% (17) | 46.7% (14) | ||
| Thoracoscopic surgery | 0.0% (0) | 3.3% (1) | ||
| Prone-position surgery | 3.2% (1) | 6.7% (2) | ||
| Other | 41.9% (13) | 43.3% (13) | ||
| VT-T0 (ml), mean±SD | 447±72 | 448±60 | −0.10 | 0.923 |
| VT-T1 (ml), mean±SD | 463±66 | 450±60 | 0.78 | 0.439 |
| VT-T2 (ml), mean±SD | 470±68 | 450±60 | 1.22 | 0.227 |
| Anesthesia duration (min), mean±SD | 146±87 | 158±108 | −0.491 | 0.625 |
| ICU Transfer rate, n (%) | 74.2% (23) | 50.0% (15) | −1.98 | 0.053 |
| ASA – American Society of Anesthesiologists; BMI – body mass index; COPD – chronic obstructive pulmonary disease; ILD – interstitial lung disease; VT – tidal volume; T0 – immediately after intubation; T1 – after 60 minutes of positive end-expiratory pressure titration; T2 – end of surgery []. ** Data are presented as mean±SD or number (%), as appropriate. Comparisons between groups were conducted using the independent-samples Student’s t-test for continuous variables and the chi-square test for categorical variables. *** Frailty severity was classified according to the EFS as mild (5–6), moderate (7–8), and severe (≥9). All patients transferred to the ICU were extubated within 24 hours postoperatively to reduce bias in the assessment of postoperative pulmonary complications. **** Preoperative pulmonary diseases included COPD, asthma, ILD, and other less common conditions such as bronchiectasis or prior pulmonary tuberculosis. ***** Surgical types were categorized into laparoscopic/thoracoscopic surgery, prone-position orthopedic procedures, and other types. ****** | ||||