Abstract
Introduction: This study is aimed to assess the efficacy of prophylactic CPAP on the development of atelectasis/pneumonias in the immediate postoperative period.
Methods: We present the intermediate intention-to-treat analysis of a multicenter phase III, randomized, controlled clinical trial (ClinicalTrials.gov identifier: NCT01471189). Inclusion criteria are: being submitted to LRS lasting > 2h, weaning performed within the 4 hours following the intervention and not known OAHS, immunosuppression or significant bullous emphysema. So far 333 patients have been included at four university hospitals of Madrid. All participants signed an informed consent prior to their participation. The study was approved by the Madrid regional review board. On the admission to the PACU, patients were randomized to CPAP 7cmH2O (n=168)+customary care or customary care alone (n=165). A part from atelectasis/pneumonias other postoperative complications as well as persistent air leaks occurring within 30 day from the intervention were recorded.
Results: There were no differences between the two groups at enrollment (Age=64±10; FEV1p=90±22%. mean ASA=2.4±0.6). Atelectasis/pneumonias occurred in 32(19%) of the CPAP group and in 45(27.3%) of the control group p=0.06. But If we adjust the rates for age, p is statistically significant (p=0.03); OR 0.619 ( CI 95 % 0. 4–0.9). The incidence of persistent air leaks was 15 (10%) in the CPAP group and 13 (8%) in the control group p=0.232.
Conclussions: Prophylactic postoperative CPAP reduces the incidence of atelectasis/pneumonia while it does not increase significantly prolonged air leaks.
- Copyright ©the authors 2016
