Continuous Positive Airway Pressure Versus Oxygen Therapy in the Cardiac Surgical Ward: A Randomized Trial

Background Noninvasive ventilation (NIV) is a common technique to manage patients with acute respiratory failure in the intensive care unit. However, use of NIV in general wards is less well described. The authors’ aim was to demonstrate efficacy of NIV, applied in a cardiac surgery ward, in improvi...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2017-02, Vol.31 (1), p.115-121
Main Authors: Olper, Luigi, PT, Bignami, Elena, MD, Di Prima, Ambra L., MD, Albini, Santina, PT, Nascimbene, Simona, MD, Cabrini, Luca, MD, Landoni, Giovanni, MD, Alfieri, Ottavio, MD
Format: Article
Language:English
Subjects:
Acute Disease
Aged
anesthesia
Anesthesia & Perioperative Care
cardiac surgery
Cardiac Surgical Procedures - adverse effects
Continuous Positive Airway Pressure - adverse effects
Continuous Positive Airway Pressure - methods
Critical Care
Female
Humans
Hypoxia - blood
Hypoxia - etiology
Hypoxia - therapy
Male
Middle Aged
noninvasive ventilation
Oxygen - blood
Oxygen Inhalation Therapy - methods
Partial Pressure
Point-of-Care Systems
postoperative care
Postoperative Care - methods
Respiratory Insufficiency - blood
Respiratory Insufficiency - etiology
Respiratory Insufficiency - therapy
respiratory therapy
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Summary:Background Noninvasive ventilation (NIV) is a common technique to manage patients with acute respiratory failure in the intensive care unit. However, use of NIV in general wards is less well described. The authors’ aim was to demonstrate efficacy of NIV, applied in a cardiac surgery ward, in improving oxygenation in patients who developed hypoxemic acute respiratory failure after being discharged from the intensive care unit. Design Randomized, open-label trial. Setting University hospital. Participants Sixty-four patients with hypoxemia (PaO2 /FI O2 ratio between 100 and 250) admitted to the main ward after cardiac surgery. Interventions Patients were randomized to receive standard treatment (oxygen, early mobilization, a program of breathing exercises and diuretics) or continuous positive airway pressure in addition to standard treatment. Continuous positive airway pressure was administered 3 times a day for 2 consecutive days. Every cycle lasted 1 to 3 hours. All patients completed their 1-year follow-up. Data were analyzed according to the intention-to-treat principle. Measurements and Main Results The primary endpoint was the number of patients with PaO2 /FI O2
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2016.08.007