Abstract
Background: Despite advances in perioperative care and surgical techniques, patients undergoing pulmonary lobectomy are still at high risk for postoperative complications. Among interventions expected to reduce complications, continuous positive airway pressure (CPAP) is a discussed option. This trial aims to test the hypothesis whether prophylactic application of CPAP following pulmonary lobectomy can reduce postoperative complications. Methods: The study was designed as a prospective, randomized, controlled trial. Patients with clinical stage I non-small cell lung cancer scheduled for pulmonary lobectomy were eligible and were trained for the use of CPAP interface. The control group received standard postoperative pain management and physiotherapy; in addition, the study group received CPAP (PEEP 8-12 cmH2O, 2 hours thrice daily for three days). Results: After the appropriate selection, 163 patients were considered for the analysis: 82 patients constituted the control group, 81 the study group. The two groups were substantially comparable for preoperative parameters. The rate of postoperative complications was lower in the study group (24.7% vs. 43.9%; P=0.015) as well as the hospital stay (6 vs. 7 days; P=0.031). The stepwise logistic regression model identified: CPAP [odd ratio (OR): 0.3026, CI: 0.1389-0.6591], smoke habits [OR: 2.5835, confidence interval (CI): 1.0331-6.4610] and length of surgery in minutes (OR: 1.0102, CI: 1.0042-1.0163) as regressors on postoperative complications. Conclusions: The present trial demonstrated that prophylactic application of CPAP during the postoperative period after pulmonary lobectomy for stage I non-small cell lung cancer was effective in prevent postoperative complications.
| Original language | English |
|---|---|
| Pages (from-to) | 2829-2836 |
| Number of pages | 8 |
| Journal | Journal of Thoracic Disease |
| Volume | 10 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 1 2018 |
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Keywords
- Continuous positive airway pressure (CPAP)
- Lung neoplasms
- Postoperative complications
- Thoracic surgery
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
Prophylactic continuous positive airway pressure after pulmonary lobectomy : A randomized controlled trial. / Palleschi, Alessandro; Privitera, Emilia; Lazzeri, Marta; Mariani, Sara; Rosso, Lorenzo; Tosi, Davide; Mendogni, Paolo; Righi, Ilaria; Carrinola, Rosaria; Montoli, Matteo; Reda, Marco; Torre, Massimo; Santambrogio, Luigi; Nosotti, Mario.
In: Journal of Thoracic Disease, Vol. 10, No. 5, 01.05.2018, p. 2829-2836.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prophylactic continuous positive airway pressure after pulmonary lobectomy
T2 - A randomized controlled trial
AU - Palleschi, Alessandro
AU - Privitera, Emilia
AU - Lazzeri, Marta
AU - Mariani, Sara
AU - Rosso, Lorenzo
AU - Tosi, Davide
AU - Mendogni, Paolo
AU - Righi, Ilaria
AU - Carrinola, Rosaria
AU - Montoli, Matteo
AU - Reda, Marco
AU - Torre, Massimo
AU - Santambrogio, Luigi
AU - Nosotti, Mario
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background: Despite advances in perioperative care and surgical techniques, patients undergoing pulmonary lobectomy are still at high risk for postoperative complications. Among interventions expected to reduce complications, continuous positive airway pressure (CPAP) is a discussed option. This trial aims to test the hypothesis whether prophylactic application of CPAP following pulmonary lobectomy can reduce postoperative complications. Methods: The study was designed as a prospective, randomized, controlled trial. Patients with clinical stage I non-small cell lung cancer scheduled for pulmonary lobectomy were eligible and were trained for the use of CPAP interface. The control group received standard postoperative pain management and physiotherapy; in addition, the study group received CPAP (PEEP 8-12 cmH2O, 2 hours thrice daily for three days). Results: After the appropriate selection, 163 patients were considered for the analysis: 82 patients constituted the control group, 81 the study group. The two groups were substantially comparable for preoperative parameters. The rate of postoperative complications was lower in the study group (24.7% vs. 43.9%; P=0.015) as well as the hospital stay (6 vs. 7 days; P=0.031). The stepwise logistic regression model identified: CPAP [odd ratio (OR): 0.3026, CI: 0.1389-0.6591], smoke habits [OR: 2.5835, confidence interval (CI): 1.0331-6.4610] and length of surgery in minutes (OR: 1.0102, CI: 1.0042-1.0163) as regressors on postoperative complications. Conclusions: The present trial demonstrated that prophylactic application of CPAP during the postoperative period after pulmonary lobectomy for stage I non-small cell lung cancer was effective in prevent postoperative complications.
AB - Background: Despite advances in perioperative care and surgical techniques, patients undergoing pulmonary lobectomy are still at high risk for postoperative complications. Among interventions expected to reduce complications, continuous positive airway pressure (CPAP) is a discussed option. This trial aims to test the hypothesis whether prophylactic application of CPAP following pulmonary lobectomy can reduce postoperative complications. Methods: The study was designed as a prospective, randomized, controlled trial. Patients with clinical stage I non-small cell lung cancer scheduled for pulmonary lobectomy were eligible and were trained for the use of CPAP interface. The control group received standard postoperative pain management and physiotherapy; in addition, the study group received CPAP (PEEP 8-12 cmH2O, 2 hours thrice daily for three days). Results: After the appropriate selection, 163 patients were considered for the analysis: 82 patients constituted the control group, 81 the study group. The two groups were substantially comparable for preoperative parameters. The rate of postoperative complications was lower in the study group (24.7% vs. 43.9%; P=0.015) as well as the hospital stay (6 vs. 7 days; P=0.031). The stepwise logistic regression model identified: CPAP [odd ratio (OR): 0.3026, CI: 0.1389-0.6591], smoke habits [OR: 2.5835, confidence interval (CI): 1.0331-6.4610] and length of surgery in minutes (OR: 1.0102, CI: 1.0042-1.0163) as regressors on postoperative complications. Conclusions: The present trial demonstrated that prophylactic application of CPAP during the postoperative period after pulmonary lobectomy for stage I non-small cell lung cancer was effective in prevent postoperative complications.
KW - Continuous positive airway pressure (CPAP)
KW - Lung neoplasms
KW - Postoperative complications
KW - Thoracic surgery
UR - http://www.scopus.com/inward/record.url?scp=85047970739&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047970739&partnerID=8YFLogxK
U2 - 10.21037/jtd.2018.05.46
DO - 10.21037/jtd.2018.05.46
M3 - Article
AN - SCOPUS:85047970739
VL - 10
SP - 2829
EP - 2836
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
SN - 2072-1439
IS - 5
ER -