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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 6/2011

01.06.2011 | Review

Non-invasive ventilation in postoperative patients: a systematic review

verfasst von: D. Chiumello, G. Chevallard, C. Gregoretti

Erschienen in: Intensive Care Medicine | Ausgabe 6/2011

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Abstract

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.
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Metadaten
Titel
Non-invasive ventilation in postoperative patients: a systematic review
verfasst von
D. Chiumello
G. Chevallard
C. Gregoretti
Publikationsdatum
01.06.2011
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 6/2011
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-011-2210-8

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