title: Noninvasive ventilation reduces mortality in acute respiratory failure following lung resection.
abstract: When treated with invasive endotracheal mechanical ventilation (ETMV), acute respiratory insufficiency after lung resection is fatal in up to 80% of cases. Noninvasive positive-pressure ventilation (NPPV) may reduce the need for ETMV, thereby improving survival. We conducted a randomized prospective trial to compare standard therapy with and without nasal-mask NPPV in patients with acute hypoxemic respiratory insufficiency after lung resection. The primary outcome variable was the need for ETMV and the secondary outcome variables were in-hospital and 120-d mortality rates, duration of stay in the intensive care unit, and duration of in-hospital stay. Twelve of the 24 patients (50%) randomly assigned to the no-NPPV group required ETMV, versus only five of the 24 patients (20.8%) in the NPPV group (p = 0.035). Nine patients in the no-NPPV group died (37.5%), and three (12.5 %) patients in the NPPV group died (p = 0.045). The other secondary outcomes were similar in the two groups. NPPV is safe and effective in reducing the need for ETMV and improving survival after lung resection.
authors.affiliation: Surgical Intensive Care Unit, Marie Lannelongue Surgical Center, Le Plessis Robinson, France. auriant@ccml.com
authors.forename: I
authors.initials: I
authors.lastname: Auriant
authors.forename: A
authors.initials: A
authors.lastname: Jallot
authors.forename: P
authors.initials: P
authors.lastname: Hervé
authors.forename: J
authors.initials: J
authors.lastname: Cerrina
authors.forename: F
authors.initials: F
authors.lastname: Le Roy Ladurie
authors.forename: J L
authors.initials: JL
authors.lastname: Fournier
authors.forename: B
authors.initials: B
authors.lastname: Lescot
authors.forename: F
authors.initials: F
authors.lastname: Parquin
mesh_terms: D006801:Humans; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011175:Positive-Pressure Respiration; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D015996:Survival Rate