TY - JOUR
T1 - Non-invasive ventilation in postoperative patients: A systematic review
AU - Gregoretti, Cesare
AU - Chevallard, null
AU - Chiumello, Davide
AU - Gregoretti, null
AU - Chevallard, null
AU - Chevallard, null
AU - Chevallard, null
PY - 2011
Y1 - 2011
N2 - Background: Postoperative pulmonary complications, generally defined as any pulmonary abnormality occurring in the postoperative period, are still a significant issue in clinical practice increasing hospital length of stay, morbidity and mortality. Non-invasive ventilation (NIV), primarily applied in cardiogenic pulmonary edema, decompensated COPD and hypoxemic pulmonary failure, is nowadays also used in perioperative settings. Objective: Investigate the application and results of preventive and therapeutic NIV in postsurgical patients. Design: A systematic review. Data sources: Medical literature databases were searched for articles about "clinical trials," "randomized controlled trials" and "meta-analyses." The keywords "cardiac surgery," "thoracic surgery," "lung surgery," "abdominal surgery," "solid organ transplantation," "thoraco-abdominal surgery" and "bariatric surgery" were combined with any of these: "non-invasive positive pressure ventilation," "continuous positive airway pressure," "bilevel ventilation," "postoperative complications," "postoperative care," "respiratory care," "acute respiratory failure," "acute lung injury" and "acute respiratory distress syndrome." Results: Twenty-nine articles (N = 2,279 patients) met the inclusion criteria. Nine studies evaluated NIV in post-abdominal surgery, three in thoracic surgery, eight in cardiac surgery, three in thoraco-abdominal surgery, four in bariatric surgery and two in post solid organ transplantation used both for prophylactic and therapeutic purposes. NIV improved arterial blood gases in 15 of the 22 prophylactic and in 4 of the 7 therapeutic studies, respectively. NIV reduced the intubation rate in 11 of the 29 studies and improved outcome in only 1. Conclusions: Despite these limited data and the necessity of new randomized trials, NIV could be considered as a prophylactic and therapeutic tool to improve gas exchange in postoperative patients. © 2011 jointly held by Springer and ESICM.
AB - Background: Postoperative pulmonary complications, generally defined as any pulmonary abnormality occurring in the postoperative period, are still a significant issue in clinical practice increasing hospital length of stay, morbidity and mortality. Non-invasive ventilation (NIV), primarily applied in cardiogenic pulmonary edema, decompensated COPD and hypoxemic pulmonary failure, is nowadays also used in perioperative settings. Objective: Investigate the application and results of preventive and therapeutic NIV in postsurgical patients. Design: A systematic review. Data sources: Medical literature databases were searched for articles about "clinical trials," "randomized controlled trials" and "meta-analyses." The keywords "cardiac surgery," "thoracic surgery," "lung surgery," "abdominal surgery," "solid organ transplantation," "thoraco-abdominal surgery" and "bariatric surgery" were combined with any of these: "non-invasive positive pressure ventilation," "continuous positive airway pressure," "bilevel ventilation," "postoperative complications," "postoperative care," "respiratory care," "acute respiratory failure," "acute lung injury" and "acute respiratory distress syndrome." Results: Twenty-nine articles (N = 2,279 patients) met the inclusion criteria. Nine studies evaluated NIV in post-abdominal surgery, three in thoracic surgery, eight in cardiac surgery, three in thoraco-abdominal surgery, four in bariatric surgery and two in post solid organ transplantation used both for prophylactic and therapeutic purposes. NIV improved arterial blood gases in 15 of the 22 prophylactic and in 4 of the 7 therapeutic studies, respectively. NIV reduced the intubation rate in 11 of the 29 studies and improved outcome in only 1. Conclusions: Despite these limited data and the necessity of new randomized trials, NIV could be considered as a prophylactic and therapeutic tool to improve gas exchange in postoperative patients. © 2011 jointly held by Springer and ESICM.
KW - Acute respiratory failure
KW - Atelectasis
KW - Critical Care and Intensive Care Medicine
KW - Humans
KW - Intensive Care Units
KW - Non-invasive ventilation
KW - Positive-Pressure Respiration
KW - Postoperative Care
KW - Postoperative pneumonia
KW - Acute respiratory failure
KW - Atelectasis
KW - Critical Care and Intensive Care Medicine
KW - Humans
KW - Intensive Care Units
KW - Non-invasive ventilation
KW - Positive-Pressure Respiration
KW - Postoperative Care
KW - Postoperative pneumonia
UR - http://hdl.handle.net/10447/157065
M3 - Article
VL - 37
SP - 918
EP - 929
JO - Intensive Care Medicine
JF - Intensive Care Medicine
SN - 0342-4642
ER -