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Early postoperative prophylactic noninvasive ventilation after major lung resection in COPD patients: a randomized controlled trial

Christine Lorut| Aurélie Lefebvre| Benjamin Planquette| Laurent Quinquis| Hervé Clavier| Nicola Santelmo| Halim Abou Hanna| François Bellenot| Jean-François Regnard| Marc Riquet| Pierre Magdeleinat| Guy Meyer| Nicolas Roche| Gérard Huchon| Joel Coste| Antoine Rabbat
Original Article
Volume 40, Issue 2 / February , 2014

Pages 220 - 227

Abstract

Objectives

To investigate whether prophylactic postoperative NIV prevents respiratory complications following lung resection surgery in COPD patients.

Methods

In seven thoracic surgery departments, 360 COPD patients undergoing lung resection surgery were randomly assigned to two groups: conventional postoperative treatment without (n = 179) or with (n = 181) prophylactic NIV, applied intermittently during 6 h per day for 48 h following surgery. The primary endpoint was the rate of acute respiratory events (ARE) at 30 days postoperatively (ITT analysis). Secondary endpoints were acute respiratory failure (ARF), intubation rate, mortality rate, infectious and non-infectious complications, and duration of ICU and hospital stay.

Measurements and main results

ARE rates did not differ between the prophylactic NIV and control groups (57/181, 31.5 vs. 55/179, 30.7 %, p = 0.93). ARF rate was 18.8 % in the prophylactic NIV group and 24.5 % in controls (p = 0.20). Re-intubation rates were similar in the prophylactic NIV and control group [10/181 (5.5 %) and 13/179 (7.2 %), respectively, p = 0.53]. Mortality rates were 5 and 2.2 % in the control and prophylactic NIV groups, respectively (p = 0.16). Infectious and non-infectious complication rates, and duration of ICU and hospital stays were similar between groups.

Conclusions

Prophylactic postoperative NIV did not reduce the rate of ARE in COPD patients undergoing lung resection surgery and did not influence other postoperative complications rates, mortality rates, and duration of ICU and hospital stay.

Keywords

References

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