Prophylactic nasal continuous positive airway pressure after major vascular surgery: results of a prospective randomized trial
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- Böhner, H., Kindgen-Milles, D., Grust, A. et al. Langenbeck's Arch Surg (2002) 387: 21. doi:10.1007/s00423-002-0281-2
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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. Patients/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 paO2<70 mmHg with FiO2≥ 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. Conclusion: 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.