BACKGROUND: Non-invasive ventilation (NIV) has become a standard of care in acute respiratory failure. However, little data is available on its usefulness in recovery ward patients after general surgery. The present study aimed to document the feasibility of implementing NIV in this setting, and its impact on lung function. METHODS: During a 12-month period, all adult patients who underwent elective general surgical procedures under general anaesthesia during weekdays, were transferred to the recovery ward after extubation, and those who required NIV were included in this prospective observational study. NIV was applied with a bilevel device (VPAP II ST, ResMed, North Ryde, Australia). RESULTS: 4622 patients were admitted to the recovery ward, 83 of whom needed NIV. NIV increased pH (7.38 +/- .06 vs 7.30 +/- .05), reduced PaCO2 (7.38 +/- .06 vs 7.30 +/- .05) in hypercapnic patients (44 +/- 9 vs 55 +/- 10 mm Hg), and increased PaO2 in non-hypercapnic patients (80 +/- 10 vs 70 +/- 11 mm Hg). No complications attributable to NIV occurred. Most patients improved after 1-2 NIV trials, and all were transferred to the ward the same day. CONCLUSIONS: In recovery ward patients after general surgery, NIV is seldom required. When applied, NIV seems to exert favourable effects on lung function. NIV can be safely implemented with a bilevel device in a recovery ward not accustomed to the use of ICU ventilators. The cost-effectiveness of its systematic use in this setting should be assessed.
BACKGROUND: Non-invasive ventilation (NIV) has become a standard of care in acute respiratory failure. However, little data is available on its usefulness in recovery ward patients after general surgery. The present study aimed to document the feasibility of implementing NIV in this setting, and its impact on lung function. METHODS: During a 12-month period, all adult patients who underwent elective general surgical procedures under general anaesthesia during weekdays, were transferred to the recovery ward after extubation, and those who required NIV were included in this prospective observational study. NIV was applied with a bilevel device (VPAP II ST, ResMed, North Ryde, Australia). RESULTS: 4622 patients were admitted to the recovery ward, 83 of whom needed NIV. NIV increased pH (7.38 +/- .06 vs 7.30 +/- .05), reduced PaCO2 (7.38 +/- .06 vs 7.30 +/- .05) in hypercapnic patients (44 +/- 9 vs 55 +/- 10 mm Hg), and increased PaO2 in non-hypercapnicpatients (80 +/- 10 vs 70 +/- 11 mm Hg). No complications attributable to NIV occurred. Most patients improved after 1-2 NIV trials, and all were transferred to the ward the same day. CONCLUSIONS: In recovery ward patients after general surgery, NIV is seldom required. When applied, NIV seems to exert favourable effects on lung function. NIV can be safely implemented with a bilevel device in a recovery ward not accustomed to the use of ICU ventilators. The cost-effectiveness of its systematic use in this setting should be assessed.
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