title: Prophylactic nasal continuous positive airway pressure after major vascular surgery: results of a prospective randomized trial.
abstract: BACKGROUND
  The efficacy of nasal continuous positive airway pressure (nCPAP) as a prophylactic method for preventing cardiopulmonary complications after major vascular surgery has not been investigated.
  
  
  METHODS
  In a prospective randomized trial, 204 patients undergoing elective midline laparotomy for vascular surgery were randomized to receive standard therapy ( n=105) or additional prophylactic nCPAP ( n=99) for the first postoperative night. Postoperative oxygenation, incidence of severe cardiac, and pulmonary complications, length of intensive care surveillance and length of total postoperative hospital stay (LOS) were compared.
  
  
  RESULTS
  Prophylactic nCPAP significantly reduced the number of patients with severe oxygenation disturbances defined as paO(2) < 70 mmHg with FiO(2) > or = 0.7 (5 versus 17, P=.01). There were no differences with respect to death, cardiac and pulmonary complications, length of intensive care surveillance or LOS.
  
  
  CONCLUSIONS
  Prophylactic 12 h nCPAP significantly reduces the occurrence of postoperative oxygenation disturbances but has no effect on cardiac or pulmonary complications, need for intensive care, LOS or mortality after major vascular surgery.
authors: Department of Vascular Surgery and Kidney Transplantation, Heinrich-Heine University, Moorenstrasse 5, 40225 Düsseldorf, Germany. Boehner@med.uni-duesseldorf.de
authors: Hinrich
authors: H
authors: Böhner
authors: Detlef
authors: D
authors: Kindgen-Milles
authors: Andreas
authors: A
authors: Grust
authors: Rolf
authors: R
authors: Buhl
authors: Wolf-Christian
authors: WC
authors: Lillotte
authors: Barbara T
authors: BT
authors: Müller
authors: Eckhard
authors: E
authors: Müller
authors: Günter
authors: G
authors: Fürst
authors: Wilhelm
authors: W
authors: Sandmann
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000517:prevention & control*; D014656:Vascular Surgical Procedures / Q000534:rehabilitation*