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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