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Clinical Investigations: Surgery: ArticlesNoninvasive Ventilatory Support After Lung Resectional Surgery
Section snippets
Subjects
This investigation was approved by the Ethics Committee of the Hospital Universitari Son Dureta. Written consent was obtained from all participants after they were fully informed of the nature, characteristics, aims, and potential risks of the study. All patients scheduled for elective lung resection in our hospital during the study period were initially considered potential candidates. Patients were excluded if one or more of these conditions occurred: (1) incisions other than posterolateral
Results
Twenty-two patients initially entered the study. However, two patients were excluded before randomization because of hemodynamic instability. Twenty patients were randomized (10 in each group). One of the patients allocated in the study group requested to withdraw from the study because of nasal mask intolerance. The remaining 19 patients completed the study. Indications for surgery in these patients were primary lung cancer (15 patients), single metastasis to the lung (two patients), hamartoma
Discussion
This investigation evaluates the short-term physiologic effects of NIVS with a nasal ventilatory support system (BiPAP) in the immediate postoperative period of patients submitted to lung resectional surgery. Our results show that NIVS improves the efficiency of the lung as a gas exchanger (PaO2 increased and P[A-a]O2 decreased) without causing any deleterious side effect, such as increasing VD/VT, pleural air leakage, or jeopardizing the hemodynamic condition of the patient.
Previous studies
ACKNOWLEDGMENTS
The authors thank M. Llobera, MD, and C. Montero, MD (Thoracic Surgery Unit, Hospital Universitari Son Dureta) for their cooperation during the surgical procedures, and the nursing staff of the Hospital Universitari Son Dureta, particularly M. Bosch and F. Bauzá, for their help during the studies.
References (14)
Respiratory aspects of anaesthesia
- et al.
Pressure support ventilation with a simplified ventilatory support system administered with a nasal mask in patients with respiratory failure
Chest
(1991) - et al.
Noninvasive nasal mask ventilation for acute respiratory failure: institution of a new therapeutic technology for routine use
Chest
(1994) - et al.
Noninvasive pressure support ventilation in patients with acute respiratory failure
Chest
(1993) - et al.
Prevention of postoperative pulmonary complications with CPAP, incentive spirometry, and conservative therapy
Chest
(1985) - et al.
Nasal continuous positive airway pressure in atelectasis
Chest
(1987) Surgical considerations: effects of surgery on lung function
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Supported, in part, by Fondo de Investigaciones Sanitarias de la Seguridad Social (FIS 93/0855), ABEMAR, and a research grant from Carburos Metálicos SA.