Correspondence  |   April 2017
In Reply
Author Notes
  • University Hospital Zurich, Zurich, Switzerland (B.B.-S.).
  • (Accepted for publication November 6, 2016.)
    (Accepted for publication November 6, 2016.)×
Article Information
Correspondence   |   April 2017
In Reply
Anesthesiology 4 2017, Vol.126, 756-757. doi:10.1097/ALN.0000000000001559
Anesthesiology 4 2017, Vol.126, 756-757. doi:10.1097/ALN.0000000000001559
We would like to thank de la Gala et al. for their interest in this clinical trial.
First, the authors raise a concern about differences between the groups in amount of fluids given and the depth of anesthesia. It is important for any trial in perioperative pulmonary medicine to set rules for volume management, hemodynamics, and plateau pressure during ventilation as potential confounders in the study protocol. We were well aware of this issue and therefore established a detailed protocol for the study centers with only very few protocol violations as reported. In this large trial with 460 patients, we trusted the power of randomization to eliminate differences in these covariates between the two study arms.1  As a consequence, we are not concerned about the issues raised by the authors of the letter. The same argumentation applies to the Bispectral Index. The protocol instructed investigators to achieve Bispectral Index values of 40 to 60.
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