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. 2018 Jul 9;2018(7):CD011151. doi: 10.1002/14651858.CD011151.pub3

Kuzkov 2016.

Methods RCT with parallel groups
Approved by the ethics committee
Written informed consents obtained
Site: Northern State Medical University, Arkhangelsk, Russian Federation
Setting: University hospital
Dates of data collection: 2014–2016
Participants 60 adults scheduled for elective pancreatoduodenal surgery with duration > 2 hours
Interventions Treatment group: tidal volume 6 mL/kg of predicted body weight with (PaCO2 45–60 mmHg; n = 20) or without (PaCO2 32–48 mmHg; n = 20) moderate hypercapnia
Control group: tidal volume 10 mL/kg of predicted body weight (n = 20)
In all the groups, PEEP 4 cmH2O was set.
Outcomes Relevant to this review

  1. Mortality

  2. Pneumonia

  3. ICU length of stay

  4. Hospital length of stay


Others

  1. Tidal volumes

  2. PaO2/FiO2 ratio

  3. Atelectasia

  4. Arterial lactate and bicarbonate excess values
Notes Funding: supported, in part, by the Grant of the President of Russian Federation (grant number MD‐4984.2015.7)
Declaration of interest: none mentioned
All participants were routinely kept on invasive ventilation after surgery, therefore this outcome was not entered in the analysis.
Email send to authors to obtain results for ICU length of stay on 10 June 2017. No reply received
Volume per body weight: predicted body weight, no further details
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Before anaesthesia and start of mechanical ventilation, participants were randomized using the envelope method
Allocation concealment (selection bias) Low risk See above
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Not mentioned
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Tracheal extubation was performed in the ICU by an independent ICU physician on predetermined criteria.
Chest X‐rays were interpreted by an independent specialist.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No lost to follow‐up
Selective reporting (reporting bias) Low risk All results reported
Other bias Unclear risk Groups well balanced except for smoking that was significantly lower in the high tidal volume group (P = 0.03)