Prophylactic Use of Helmet CPAP After Pulmonary Lobectomy: A Prospective Randomized Controlled Study
| Autor: | Eveline Internullo, Luca Ampollini, Andrea Ortu, Maria Barbagallo, Alessandra Salvadori, Stefanie Ziegler, Guido Fanelli, Elisabetta Spadini |
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| Rok vydání: | 2012 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry Standard treatment medicine.medical_treatment General Medicine Respiratory physiology Oxygenation Critical Care and Intensive Care Medicine Surgery law.invention Pneumonectomy Randomized controlled trial law Oxygen therapy Anesthesia medicine Continuous positive airway pressure business Prospective cohort study |
| Zdroj: | Respiratory Care. 57:1418-1424 |
| ISSN: | 1943-3654 0020-1324 |
| DOI: | 10.4187/respcare.00838 |
| Popis: | Background Patients undergoing pulmonary lobectomy carry a high risk of respiratory complications after surgery. The postoperative prophylactic treatment with helmet CPAP may prevent postoperative acute respiratory failure and improve the P(aO(2))/F(IO(2)). Methods We randomly allocated 50 subjects to receive continuous oxygen therapy (air-entrainment mask, F(IO(2)) 0.4) or 2 cycles of helmet CPAP for 120 min, alternating with analog oxygen therapy for 4 hours. Blood gas values were collected at admission to ICU, after 1, 3, 7, 9, 24 hours, and then in the thoracic ward after 48 hours and one week after surgery. We investigated the incidence of postoperative complications, mortality, and length of hospital stay. Results At the end of the second helmet CPAP treatment, the subjects had a significantly higher P(aO(2))/F(IO(2)), compared with the control group (366 ± 106 mm Hg vs 259 ± 60 mm Hg, P = .004), but the improvement in oxygenation did not continue beyond 24 hours. The postoperative preventive helmet CPAP treatment was associated with a significantly shorter hospital stay, in comparison to standard treatment (7 ± 4 d and 8 ± 13 d, respectively, P = .042). The number of minor or major postoperative complications was similar between the 2 groups. No difference in ICU readmission or mortality was observed. Conclusions The prophylactic use of helmet CPAP improved the P(aO(2))/F(IO(2)), but the oxygenation benefit was not lasting. In our study, helmet CPAP was a secure and well tolerated method in subjects who underwent pulmonary lobectomy. It might be safely applied whenever necessary. |
| Databáze: | OpenAIRE |
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