Postoperative Non-Invasive Ventilation after Upper Abdominal Surgery in Chronic Obstructive Lung Disease | ||||
| SVU-International Journal of Medical Sciences | ||||
| Article 92, Volume 7, Issue 1, January 2024, Page 580-591 PDF (267.01 K) | ||||
| Document Type: Original research articles | ||||
| DOI: 10.21608/svuijm.2021.74964.1176 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Gad Sayed Gad; Salah Mostafe Asida; Asmaa Mohamed Mostafa  ; Mahmoud Mohamed Ahmed
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| Department of Anesthesia, ICU, and Pain Management, Faculty of Medicine, South Valley University, Qena, Egypt | ||||
| Abstract | ||||
| Background: Chronic obstructive pulmonary disease (COPD) is a major risk factor for respiratory problems during extra-pulmonary surgery Objectives: To investigate postoperative NIV in COPD patients following upper abdominal surgery to prevent pulmonary complications. Patients and methods: In Qena University Hospital a prospective, randomized study was carried out on 100 COPD patients, all were divided into; conventional therapy without NIV (C group) 50 patients or with prophylactic NIV(N group) 50 patients.NIV applied for approximately 30 to 45 min at 2- to 4-h intervals for 48 h following surgery . Acute respiratory events ARE were the primary outcomes, while acute respiratory failure ARF, invasive ventilation, mortality rate, complications as pneumonia, NIV intolerance, and ICU stay were secondary outcomes. Results: This study demonstrated a significant improvement in Spirometric and arterial blood gas values in N group. A total of 33 patients experienced ARE during the ICU days after surgery, 14 in N group and19 in C group (p = 0.39) . ARF occurred in 21 patients, including 9 in N group and 12 in C group (p = 0.43). five patients required invasive ventilation (3 in N group, 2 in C group). Postoperative pneumonia, atelectasis and ICU stay were similar between groups. NIV was applied as first-line rescue therapy in 6 patients N group, 10 patients in C group (p = 0.05). Heart disease comorbidity p = 0.01 and COPD with FEV1˂60 % predicted p = 0.03 are significant risk factors with ARE. Conclusion: Prophylactic NIV improved oxygenation and spirometry values, with no reduction in the rate of acute respiratory failure, invasive ventilation, mortality and ICU stay. | ||||
| Keywords | ||||
| Noninvasive ventilation; COPD; Abdominal surgery; Acute respiratory failure | ||||
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