BACKGROUND: The efficacy of nasal continuous positive airway pressure (nCPAP) as a prophylactic method for preventing cardiopulmonary complications after major vascular surgery has not been investigated. PATIENTS/ METHODS: In a prospective randomized trial, 204 patients undergoing elective midline laparotomy for vascular surgery were randomized to receive standard therapy ( n=105) or additional prophylacticnCPAP ( n=99) for the first postoperative night. Postoperative oxygenation, incidence of severe cardiac, and pulmonary complications, length of intensive care surveillance and length of total postoperative hospital stay (LOS) were compared. RESULTS:Prophylactic nCPAP significantly reduced the number of patients with severe oxygenation disturbances defined as paO(2) < 70 mmHg with FiO(2) > or = 0.7 (5 versus 17, P=.01). There were no differences with respect to death, cardiac and pulmonary complications, length of intensive care surveillance or LOS. CONCLUSION:Prophylactic 12 h nCPAP significantly reduces the occurrence of postoperative oxygenation disturbances but has no effect on cardiac or pulmonary complications, need for intensive care, LOS or mortalityafter major vascular surgery.
RCT Entities:
BACKGROUND: The efficacy of nasal continuous positive airway pressure (nCPAP) as a prophylactic method for preventing cardiopulmonary complications after major vascular surgery has not been investigated. PATIENTS/ METHODS: In a prospective randomized trial, 204 patients undergoing elective midline laparotomy for vascular surgery were randomized to receive standard therapy ( n=105) or additional prophylactic nCPAP ( n=99) for the first postoperative night. Postoperative oxygenation, incidence of severe cardiac, and pulmonary complications, length of intensive care surveillance and length of total postoperative hospital stay (LOS) were compared. RESULTS: Prophylactic nCPAP significantly reduced the number of patients with severe oxygenation disturbances defined as paO(2) < 70 mmHg with FiO(2) > or = 0.7 (5 versus 17, P=.01). There were no differences with respect to death, cardiac and pulmonary complications, length of intensive care surveillance or LOS. CONCLUSION: Prophylactic 12 h nCPAP significantly reduces the occurrence of postoperative oxygenation disturbances but has no effect on cardiac or pulmonary complications, need for intensive care, LOS or mortality after major vascular surgery.
Authors: Genevieve Christina Digby; Sean P Keenan; Christopher M Parker; Tasnim Sinuff; Karen E Burns; Sangeeta Mehta; Juan J Ronco; Demetrios J Kutsogiannis; Louise Rose; Najib T Ayas; Luc R Berthiaume; Christine L D'Arsigny; Daniel E Stollery; John Muscedere Journal: Can Respir J Date: 2015-10-15 Impact factor: 2.409
Authors: Sean P Keenan; Tasnim Sinuff; Karen E A Burns; John Muscedere; Jim Kutsogiannis; Sangeeta Mehta; Deborah J Cook; Najib Ayas; Neill K J Adhikari; Lori Hand; Damon C Scales; Rose Pagnotta; Lynda Lazosky; Graeme Rocker; Sandra Dial; Kevin Laupland; Kevin Sanders; Peter Dodek Journal: CMAJ Date: 2011-02-14 Impact factor: 8.262
Authors: Susan D Hanekom; Dina Brooks; Linda Denehy; Monika Fagevik-Olsén; Timothy C Hardcastle; Shamila Manie; Quinette Louw Journal: BMC Med Inform Decis Mak Date: 2012-02-06 Impact factor: 2.796