title: Early postoperative prophylactic noninvasive ventilation after major lung resection in COPD patients: a randomized controlled trial.
abstract: OBJECTIVE
  To investigate whether prophylactic postoperative NIV prevents respiratory complications following lung resection surgery in COPD patients.
  
  
  METHODS
  In seven thoracic surgery departments, 360 COPD patients undergoing lung resection surgery were randomly assigned to two groups: conventional postoperative treatment without (n = 179) or with (n = 181) prophylactic NIV, applied intermittently during 6 h per day for 48 h following surgery. The primary endpoint was the rate of acute respiratory events (ARE) at 30 days postoperatively (ITT analysis). Secondary endpoints were acute respiratory failure (ARF), intubation rate, mortality rate, infectious and non-infectious complications, and duration of ICU and hospital stay.
  
  
  RESULTS
  ARE rates did not differ between the prophylactic NIV and control groups (57/181, 31.5 vs. 55/179, 30.7%, p = 0.93). ARF rate was 18.8% in the prophylactic NIV group and 24.5% in controls (p = 0.20). Re-intubation rates were similar in the prophylactic NIV and control group [10/181 (5.5%) and 13/179 (7.2%), respectively, p = 0.53]. Mortality rates were 5 and 2.2% in the control and prophylactic NIV groups, respectively (p = 0.16). Infectious and non-infectious complication rates, and duration of ICU and hospital stays were similar between groups.
  
  
  CONCLUSIONS
  Prophylactic postoperative NIV did not reduce the rate of ARE in COPD patients undergoing lung resection surgery and did not influence other postoperative complications rates, mortality rates, and duration of ICU and hospital stay.
authors.affiliation: Service de pneumologie et USIR, Department of Respiratory and Intensive Care Medicine, Cochin-Broca-Hôtel-Dieu Hospital Group, Site Cochin, AP-HP, University Paris5, René Descartes, 27 rue du Faubourg Saint Jacques, 75679, Paris cedex 14, France. christine.lorut@cch.aphp.fr.
authors.forename: Christine
authors.initials: C
authors.lastname: Lorut
authors.affiliation: Service de pneumologie et USIR, Department of Respiratory and Intensive Care Medicine, Cochin-Broca-Hôtel-Dieu Hospital Group, Site Cochin, AP-HP, University Paris5, René Descartes, 27 rue du Faubourg Saint Jacques, 75679, Paris cedex 14, France.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Lefebvre
authors.affiliation: Department of Respiratory and Intensive Care Medicine, European Georges Pompidou Hospital, AP-HP, University Paris5, René Descartes, Paris, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Planquette
authors.affiliation: Department of Biostatistics and Epidemiology, Hôtel-Dieu Hospital, AP-HP, University Paris5, René Descartes, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Quinquis
authors.affiliation: Department of intensive care Medicine, Institut Montsouris Hospital, Paris, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Clavier
authors.affiliation: Department of Thoracic Surgery, University Hospital, Strasbourg, France.
authors.forename: Nicola
authors.initials: N
authors.lastname: Santelmo
authors.affiliation: Department of Thoracic Surgery, University Hospital, Dijon, France.
authors.forename: Halim Abou
authors.initials: HA
authors.lastname: Hanna
authors.affiliation: Department of Thoracic Surgery, University Hospital, Pontoise, France.
authors.forename: François
authors.initials: F
authors.lastname: Bellenot
authors.affiliation: Department of Thoracic Surgery, Cochin-Broca-Hôtel-Dieu Hospital Group, AP-HP, University Paris5, René Descartes, Paris, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Regnard
authors.affiliation: Department of Thoracic Surgery, European Georges Pompidou Hospital, AP-HP, University Paris5, René Descartes, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Riquet
authors.affiliation: Department of Thoracic Surgery, Institut Montsouris Hospital, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Magdeleinat
authors.affiliation: Department of Respiratory and Intensive Care Medicine, European Georges Pompidou Hospital, AP-HP, University Paris5, René Descartes, Paris, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Meyer
authors.affiliation: Service de pneumologie et USIR, Department of Respiratory and Intensive Care Medicine, Cochin-Broca-Hôtel-Dieu Hospital Group, Site Cochin, AP-HP, University Paris5, René Descartes, 27 rue du Faubourg Saint Jacques, 75679, Paris cedex 14, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Roche
authors.affiliation: Service de pneumologie et USIR, Department of Respiratory and Intensive Care Medicine, Cochin-Broca-Hôtel-Dieu Hospital Group, Site Cochin, AP-HP, University Paris5, René Descartes, 27 rue du Faubourg Saint Jacques, 75679, Paris cedex 14, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Huchon
authors.affiliation: Department of Biostatistics and Epidemiology, Hôtel-Dieu Hospital, AP-HP, University Paris5, René Descartes, Paris, France.
authors.forename: Joel
authors.initials: J
authors.lastname: Coste
authors.affiliation: Service de pneumologie et USIR, Department of Respiratory and Intensive Care Medicine, Cochin-Broca-Hôtel-Dieu Hospital Group, Site Cochin, AP-HP, University Paris5, René Descartes, 27 rue du Faubourg Saint Jacques, 75679, Paris cedex 14, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Rabbat
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation; D011013:Pneumonectomy / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery*; D013997:Time Factors