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Intensive Care Med. 2014 Feb;40(2):220-7. doi: 10.1007/s00134-013-3150-2. Epub 2013 Nov 29.

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

Author information

1
Service de pneumologie et USIR, Department of Respiratory and Intensive Care Medicine, Cochin-Broca-Hôtel-Dieu Hospital Group, Site Cochin, AP-HP, University Paris5, René Descartes, 27 rue du Faubourg Saint Jacques, 75679, Paris cedex 14, France, christine.lorut@cch.aphp.fr.

Erratum in

  • Intensive Care Med. 2014 Mar;40(3):469. Revel, Marie-Pierre [added].

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.

PMID:
24292873
DOI:
10.1007/s00134-013-3150-2
[Indexed for MEDLINE]

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