Postoperative Non-Invasive Ventilation after Upper Abdominal Surgery in Chronic Obstructive Lung Disease

Document Type : Original research articles

Authors

Department of Anesthesia, ICU, and Pain Management, Faculty of Medicine, South Valley University, Qena, Egypt

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major risk factor for respiratory problems during extra-pulmonary surgery
Objectives: To investigate postoperative NIV in COPD patients following upper abdominal surgery to prevent pulmonary complications.
 Patients and methods: In Qena University Hospital a prospective, randomized study was carried out on 100 COPD patients, all were divided into; conventional therapy without NIV (C group) 50 patients or with prophylactic NIV(N group) 50 patients.NIV applied for approximately 30 to 45 min at 2- to 4-h intervals for 48 h following surgery . Acute respiratory events ARE were the primary outcomes, while acute respiratory failure ARF, invasive ventilation, mortality rate, complications as pneumonia, NIV intolerance, and ICU stay were secondary outcomes.
Results: This study demonstrated a significant improvement in Spirometric and arterial blood gas values in N group. A total of 33 patients experienced ARE during the ICU days after surgery, 14 in N group and19 in C group (p = 0.39) . ARF occurred in 21 patients, including 9 in N group and 12 in C group (p = 0.43). five patients required invasive ventilation (3 in N group, 2 in C group). Postoperative pneumonia, atelectasis and ICU stay were similar between groups. NIV was applied as first-line rescue therapy in 6 patients N group, 10 patients in C group (p = 0.05). Heart disease comorbidity p = 0.01 and COPD with FEV1˂60 % predicted p = 0.03 are significant risk factors with ARE.
Conclusion: Prophylactic NIV improved oxygenation and spirometry values, with no reduction in the rate of acute respiratory failure, invasive ventilation, mortality and ICU stay.

Keywords

Main Subjects

Files

Share

How to cite

Statistics