Intraoperative management of mechanical ventilation in non-cardiothoracic surgery: a national survey in China

Abstract Background The current clinical practice regarding intraoperative ventilation management in non-cardiothoracic surgical setting among anesthesia providers in China is unclear. Methods We developed a 25-question anonymous survey which was distributed to anesthesia departments from 81 tertiary/university hospitals in China between August 2021 and September 2021. Information including participant characteristics, ventilatory settings, and opinions on lung-protective ventilation were obtained by electronic survey. Results were reported descriptively. Results The survey was completed by 1089 anesthesiologists from 57 institutions (70% institution response rate). The vast majority of respondents (1010/1089; 92.7%)used low tidal volume (6–8 ml kg − 1) ventilation. About three quarters (840/1089; 77.1%) utilized positive end-expiratory pressure, and most anesthesiologists set positive end-expiratory pressure of 1–5 cmH2O in either laparoscopic (639/840; 76.1%) or non-laparoscopic surgery (736/840; 87.6%). The majority of respondents (921/1089; 84.6%) performed alveolar recruitment maneuver intraoperatively. Approximate 20% of respondents routinely implemented lung-protective ventilation with bundles of low tidal volume, positive end-expiratory pressure, and alveolar recruitment maneuver. Conclusions We found that heterogeneity exists between individual practices regarding intraoperative ventilation management in the setting of non-cardiothoracic surgery, indicating the potential knowledge-practice gap among Chinese anesthesiologists. Trial registration number: ChiCTR2100047653; Registration date: June 21, 2021 Registry URL: Chictr.org.cn.