Non-invasive ventilation in the recovery room for postoperative respiratory failure: a feasibility study.
BACKGROUND
Non-invasive ventilation (NIV) has become a standard of care in acute respiratory failure. However, little data is available on its usefulness in recovery ward patients after general surgery. The present study aimed to document the feasibility of implementing NIV in this setting, and its impact on lung function.


METHODS
During a 12-month period, all adult patients who underwent elective general surgical procedures under general anaesthesia during weekdays, were transferred to the recovery ward after extubation, and those who required NIV were included in this prospective observational study. NIV was applied with a bilevel device (VPAP II ST, ResMed, North Ryde, Australia).


RESULTS
4622 patients were admitted to the recovery ward, 83 of whom needed NIV. NIV increased pH (7.38 +/- .06 vs 7.30 +/- .05), reduced PaCO2 (7.38 +/- .06 vs 7.30 +/- .05) in hypercapnic patients (44 +/- 9 vs 55 +/- 10 mm Hg), and increased PaO2 in non-hypercapnic patients (80 +/- 10 vs 70 +/- 11 mm Hg). No complications attributable to NIV occurred. Most patients improved after 1-2 NIV trials, and all were transferred to the ward the same day.


CONCLUSIONS
In recovery ward patients after general surgery, NIV is seldom required. When applied, NIV seems to exert favourable effects on lung function. NIV can be safely implemented with a bilevel device in a recovery ward not accustomed to the use of ICU ventilators. The cost-effectiveness of its systematic use in this setting should be assessed.
Battisti
Anne
A
Division of Medical Intensive Care, Cantonal University Hospital, Geneva, Switzerland.
Michotte
Jean-Bernard
JB
Tassaux
Didier
D
van Gessel
Elisabeth
E
Jolliet
Philippe
P
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D019370:Observation; D011175:Positive-Pressure Respiration; D011182:Postoperative Care / Q000379:methods*; D011184:Postoperative Period; D011997:Recovery Room; D012131:Respiratory Insufficiency / Q000628:therapy*