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Non‐invasive ventilation for treatment of postoperative respiratory failure after oesophagectomy. BJS 2009; 96: 54-60.

Published: 24th December 2008

Authors: P. Michelet, X. B. D'Journo, F. Seinaye, J. M. Forel, L. Papazian, P. Thomas et al.

Background

The aim of this case–control study was to compare the efficacy of non‐invasive positive pressure ventilation (NPPV) with that of conventional treatment in patients who develop postoperative acute respiratory failure (ARF) after oesophagectomy.

Method

Thirty‐six consecutive patients with ARF treated by NPPV were matched for diagnosis, age within 5 years, sex, preoperative radiochemotherapy and Charlson co‐morbidity index with 36 patients who received conventional treatment (control group).

Results

NPPV was associated with a lower reintubation rate (nine versus 23 patients; P = 0·008), lower frequency of acute respiratory distress syndrome (eight versus 19 patients; P = 0·015), and a reduction in intensive care stay (mean(s.d.) 14(13) versus 22(18) days; P = 0·034). Anastomotic leakage was less common in patients receiving NPPV (two versus ten; P = 0·027). These patients also showed a greater improvement in gas exchange in the first 3 days after onset of ARF (P = 0·013).

Conclusion

The use of NPPV for the treatment of postoperative ARF may decrease the incidence of endotracheal intubation and related complications, without increasing the risk of anastomotic leakage after oesophagectomy. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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