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Table 1 Table to demonstrate the components included in the CB and those which were not chosen by the Delphi consensus

From: What are the optimum components in a care bundle aimed at reducing post-operative pulmonary complications in high-risk patients?

 

Pre-operative

Intra-operative

Post-operative

In the care bundle

• Supervised exercise programme

• Inspiratory muscle training (*)

• Low tidal volume ventilation (**) with individualised PEEP

• Use of routine monitoring to avoid hyperoxia

• Limit NM blockade

• Deep breathing exercises

• Mandatory elevation of the head of the bed

Not in the care bundle

• Oropharyngeal decontamination

• Oral care package

• Chlorhexidine mouthwash or other selective oral decontamination

• Selective digestive decontamination

• Incentive spirometry

• Deep breathing exercises

• Daily pedometer targets

• Recruitment manoeuvres

• Routine use of high levels of PEEP

• Use of endotracheal tubes with specific design features, including subglottic secretion drainage

• Specific drugs or techniques to limit residual neuromuscular blockade

• Prophylactic ventilator support including CPAP, NIV or high-flow nasal oxygen

• Pharmacological therapies that aim to decrease gastro-oesophageal reflux

  1. A recommendation with (*) moderate quality or (**) strong quality evidence using GRADE or Jadad criteria