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General Thoracic and Cardiovascular Surgery

, Volume 66, Issue 10, pp 565–572 | Cite as

Clinical application of postoperative non-invasive positive pressure ventilation after lung cancer surgery

  • Satoru Okada
  • Kazuhiro Ito
  • Junichi Shimada
  • Daishiro Kato
  • Masanori Shimomura
  • Hiroaki Tsunezuka
  • Naoko Miyata
  • Shunta Ishihara
  • Tatsuo Furuya
  • Masayoshi InoueEmail author
Original Article
  • 253 Downloads

Abstract

Objective

The purpose of this study was to clarify the clinical efficacy of postoperative non-invasive positive pressure ventilation (PONIV) after pulmonary lobectomy in patients with lung cancer.

Methods

From August 2010 and July 2015, 143 patients with lung cancer who underwent pulmonary lobectomy were retrospectively reviewed. PONIV was used immediately after surgery until the morning of postoperative day (POD) 1. Arterial blood gas was analyzed before and just after surgery (POD0) and on POD1. Oxygenation ability was perioperatively assessed by PaO2/FiO2 ratio, alveolar–arterial oxygen difference (A-aDO2), and respiratory index (A-aDO2/PaO2).

Results

112 patients received PONIV. From POD0 to POD1, the PaO2/FiO2 ratio significantly improved in all patients who received PONIV (333 ± 83 to 359 ± 47 mmHg, p = 0.004). Moreover, A-aDO2 and respiratory index significantly decreased following PONIV. PONIV significantly improved the PaO2/FiO2 ratio in patients with PaO2/FiO2 ratio of ≤ 300 on POD0, older age (≥ 70 years), higher body mass index (≥ 25 kg/m2), and longer one-lung ventilation time (≥ 180 min). There was no respiratory failure requiring mechanical ventilation and no mortality.

Conclusions

PONIV effectively improved oxygenation in patients undergoing pulmonary lobectomy in patients with poor status, especially in patients with PaO2/FiO2 ratio of ≤ 300 on POD0. PONIV could be an option of perioperative management for major thoracic surgery.

Keywords

Non-invasive positive pressure ventilation Lung cancer Surgery Oxygenation 

Notes

Compliance with ethical standards

Conflict of interest

There is no conflict of interest to disclose.

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Copyright information

© The Japanese Association for Thoracic Surgery 2018

Authors and Affiliations

  • Satoru Okada
    • 1
  • Kazuhiro Ito
    • 1
  • Junichi Shimada
    • 1
  • Daishiro Kato
    • 1
  • Masanori Shimomura
    • 1
  • Hiroaki Tsunezuka
    • 1
  • Naoko Miyata
    • 1
  • Shunta Ishihara
    • 1
  • Tatsuo Furuya
    • 1
  • Masayoshi Inoue
    • 1
    Email author
  1. 1.Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan

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