Chest
Clinical InvestigationsOutcomes of Patients With Acute Respiratory Failure After Abdominal Surgery Treated With Noninvasive Positive Pressure Ventilation
Section snippets
Patient Selection and Exclusion
This study was conducted in a 12-bed surgical ICU during a 24-month period (January 1, 2000, to January 1, 2002). All patients who received NPPV for ARF after abdominal surgery were prospectively included. The study was approved by the ethics committee of the hospital. The requirement for obtaining written informed consent was waived, as this was an observational study and all procedures were considered to be routine clinical practice.
Patients were included and NPPV was performed if at least
Results
Over the 2-year period of the study, 627 patients were admitted to the unit. Among these, 463 patients were admitted for postoperative care (372 were intubated). ARF occurred in 96 patients after extubation. Eighteen patients required immediate intubation without trying to perform NPPV, and 6 patients were reintubated for surgical complications requiring a new surgical procedure. Seventy-two patients received NPPV for postoperative ARF and were included in the study. Of the 72 included patients
Discussion
This study demonstrates the feasibility and clinically efficacy of NPPV applied in selected patients with ARF after abdominal surgery in the daily practice of a surgical ICU, with an overall success rate of 67%. The role of NPPV in the treatment of hypoxemic ARF is recognized and becoming more widespread.8917 To our knowledge, no previous studies have evaluated NPPV for the treatment of ARF occurring after abdominal surgery.
Contrary to thoracic surgery,18293031 there are a few studies that
Conclusion
NPPV should be considered as an interesting alternative to conventional ventilation in selected patients after abdominal surgery with ARF who require ventilatory support. The results of our descriptive study can be the basis for a larger, prospective, randomized study comparing NPPV with conventional medical treatment.
ACKNOWLEDGMENT
The authors wish to thank the physiotherapists of the unit for their invaluable help, as well as the nurses and the rest of the personnel of the ICUs for their active participation.
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