Kudos to Phd student Hideyo Tsumura, her sponsor associate professor Debra Brandon and co-sponsors associate professor Wei Pan and professor emeritus Chuck Vacchiano for the submission of her AANA Fellowship application entitled "Characteristics and Predictive Factors of Postoperative Pulmonary Complications (PPCs) Following General Anesthesia with Mechanical Ventilation." This proposal requests funds for a 1 year period with a start date of July 1, 2020.

One in five patients who develop a postoperative pulmonary complication (PPC) dies within 30 days. Known PPC risk factors are attributable to patient factors (e.g., age, obesity), surgical factors (e.g., procedure duration, emergency status) and anesthesia factors (e.g., general anesthesia, mechanical ventilation). Specifically, ventilator induced lung injury (VILI) secondary to intraoperative mechanical ventilation is highly associated with incidence of PPC. Individualization of intraoperative ventilatory strategy is a potential solution to fill the gap for whom-when-and-how LPV can optimize surgical patient outcomes. The overarching goal of this proposed study is to examine the interactions between PPC risk stratifications and intraoperative LPV strategy to identify optimal individualized care based on patient, surgical, and anesthesia characteristics. We are proposing to conduct a retrospective study to examine intraoperative ventilatory parameters against PPC risk factors. We will utilize a case-controlled design with continuous exposure to generate hypothesis for causal relationships between PPCs and individualized ventilatory parameters. Our study population is adult surgical patients who underwent general anesthesia with mechanical ventilation excluding cardiothoracic and obstetric surgeries at Duke University Health System since 2016.