Dr Dharshi Karalapillai, A/Prof Laurence Weinberg

Austin Health study to change practices worldwide

A five-year, world first study into mechanical ventilation by researchers from Austin Health could change the way millions of surgical procedures are performed around the globe each year.

The study, published this month in the prestigious Journal of the American Medical Association (JAMA), found that the practice of inflating a patient’s lungs beyond their normal size during surgery does not reduce their risk of respiratory complications or the need for ICU admission.

Austin Health Intensive Care Physician and Anaesthetist, Dr Dharshi Karalapillai, said anaesthetists use a ventilator to inflate a patients lungs with a gas mixture including oxygen to help maintain lung function.

"It has been common practice around the world since the 1970s to inflate the patient’s lungs to almost twice their normal size when they are under anaesthetic to ensure the lungs stay open and reduce the risk of complications after surgery," Dr Karalapillai said.

"Our research looked at more than 1200 patients who underwent surgery over a number of years and found it is entirely safe to inflate a patient’s lung to their normal level while anaesthetised.

"This means millions of patients undergoing surgery around the world each year can safely receive a lower lung volume then previously thought.

Director of Intensive Care Research, Prof Rinaldo Bellomo, described the study as “an amazing piece of work”.

“A group of committed people have come together under the leadership of the Austin Health Department of Anaesthetics to challenge the status quo and deliver what is world class research,” Prof Bellomo said.

“The team were able to utilise the benefits of the Data Analytics Research and Evaluation (DARE) system set up by Austin Health in conjunction with Melbourne University which removes the burden of data collection and means information is able to be collated electronically.

“No one in the world has done this like Austin and it is incredible to see the research published in one of most highly regarded medical journals,” he said.                                                                                    

The study, ‘Effect of Intraoperative Low Tidal Volume v Conventional Tidal Volume on Postoperative Pulmonary Complications in Patients Undergoing Major Surgery’, was a collaboration between anaesthetists and intensive care specialists at Austin Health and is available at https://jamanetwork.com/journals/jama