title: Noninvasive ventilation improves the outcome of pulmonary complications after liver resection.
abstract: BACKGROUND
  Pulmonary complications are associated with increased mortality after liver resection. Although noninvasive ventilation (NIV) has proved to be an effective treatment for respiratory failure after abdominal surgery, including organ transplantation, its efficacy for pulmonary complications following liver resection per se has not been reported. The aim of this retrospective study was to investigate the effects of NIV in patients with postoperative pulmonary complications after liver resection.
  
  
  METHODS
  A retrospective single center study. Between April 2002 and March 2005, we used NIV in 16 patients who met the criteria for NIV after liver resection: respiratory failure and/or a massive atelectasis (NIV group). We also reviewed data on 10 patients who underwent liver resection from April 1999 to March 2002, and met the criteria for NIV after the operation and received conventional treatment (non-NIV group).
  
  
  RESULTS
  Respiratory-cause mortality was significantly lower in NIV group than in non-NIV group (0.0% vs. 40.0%, p=0.007), and all-cause mortality tended to be lower in NIV group (18.8% vs. 50.0%, p=0.100). After NIV treatment for 24 hours, the PaO(2)/FiO(2) ratio and PaCO(2) were improved significantly but no significant improvement was noted in non-NIV group. Rate of reintubation was significantly lower in NIV group (12.5% vs. 50.0%, p=0.040). NIV was tolerated in all 16 NIV group patients, and no severe NIV-related complications were observed.
  
  
  CONCLUSIONS
  NIV is effective in patients with respiratory failure and/or massive atelectasis after liver resection.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University.
authors.forename: Masato
authors.initials: M
authors.lastname: Narita
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Tanizawa
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
authors.forename: Iwao
authors.initials: I
authors.lastname: Ikai
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Handa
authors.forename: Toru
authors.initials: T
authors.lastname: Oga
authors.forename: Akio
authors.initials: A
authors.lastname: Niimi
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Tsuboi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Etsuro
authors.initials: E
authors.lastname: Hatano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome