Skip to main content
SpringerLink
Log in

Non-invasive Positive Pressure Ventilation in Patients Undergoing Lung Resection Surgery

  • Chapter
  • First Online:
Non-invasive Mechanical Ventilation in Critical Care, Anesthesiology and Palliative Care

  • 174 Accesses

Abstract

Lung resection surgery is frequently associated with several postoperative pulmonary complications (PPCs), among which acute respiratory failure is of concern due to the high risk of morbidity and mortality. Risk factors for PPCs are represented by older age, low independence in daily common activities, cardiovascular and pulmonary comorbidities, limited organ function reserve, previous chemotherapy/radiation, blood loss requiring large transfusion of blood products, excessive positive fluid balance and need for re-intervention. In this setting, noninvasive respiratory support strategies were demonstrated to be effective in preventing and early management of PPCs, with consequent improvement of postoperative clinical conditions. Specifically, the use of High flow nasal cannula oxygen therapy in patients who underwent cardiothoracic surgery was associated with lower reintubation rate and need to respiratory support escalation, although it had no effect on postoperative mortality. In contrast, noninvasive positive pressure ventilation was demonstrated to be effective in reducing the need for re-intubation and postoperative mortality, while the role of continuous positive airway pressure remains unclear. Further research is warranted in this field to improve the management of patients who undergo lung resection surgery and overcome the issues associated with patient and surgery heterogeneity, with limited conclusion thus far.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kirsh M, Rotman H, Behrendt D, Orringer M, Sloan H. Complications of pulmonary resection. Ann Thorac Surg. 1975;20(2):215–36.

    Article  CAS  PubMed  Google Scholar 

  2. Kutlu C, Williams E, Evans T, Pastorino U, Goldstraw P. Acute lung injury and acute respiratory distress syndrome after pulmonary resection. Ann Thorac Surg. 2000;69(2):376–80.

    Article  CAS  PubMed  Google Scholar 

  3. Leone M, Einav S, Chiumello D, Constantin J, Robertis ED, Md A, Gregoretti C, Jaber S, Maggiore S, Pelosi P, et al. Noninvasive respiratory support in the hypoxaemic peri-operative/periprocedural patient: a joint ESA/ESICM guideline. Intensive Care Med. 2020;46(4):697–713.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Jaber S, Antonelli M. Preventive or curative postoperative noninvasive ventilation after thoracic surgery: still a grey zone? Intensive Care Med. 2014;40(2):280–3.

    Article  PubMed  Google Scholar 

  5. Onugha O, Ivey R, McKenna R. Novel techniques and approaches to minimally invasive thoracic surgery. Surg Technol Int. 2017;30:231–5.

    PubMed  Google Scholar 

  6. Hernández MG, Valentín N, Alvarado IR, Gago MF, Simó GV, López MJ. Changes in the risk of mortality and morbidity after lung resection in the last 20 years. Arch Bronconeumol (Engl Ed). 2020;56(1):23–7.

    Article  Google Scholar 

  7. Agostini P, Cieslik H, Rathinam S, Bishay E, Kalkat M, Rajesh P, Steyn R, Singh S, Naidu B. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax. 2010;65(9):815–8.

    Article  CAS  PubMed  Google Scholar 

  8. Stéphan F, Boucheseiche S, Hollande J, Flahault A, Cheffi A, Bazelly B, Bonnet F. Pulmonary complications following lung resection: a comprehensive analysis of incidence and possible risk factors. Chest. 2000;118(5):1263–70.

    Article  PubMed  Google Scholar 

  9. Miserocchi G, Beretta E, Rivolta I. Respiratory mechanics and fluid dynamics after lung resection surgery. Thorac Surg Clin. 2010;20(3):345–57.

    Article  PubMed  Google Scholar 

  10. Stolz A, Schutzner J, Lischke R, Simonek J, Harustiak T, Pafko P. Predictors of atelectasis after pulmonary lobectomy. Surg Today. 2008;38(11):987–92.

    Article  PubMed  Google Scholar 

  11. Schussler O, Alifano M, Dermine H, Strano S, Casetta A, Sepulveda S, Chafik A, Coignard S, Rabbat A, Regnard J. Postoperative pneumonia after major lung resection. Am J Respir Crit Care Med. 2006;173(10):1161–9.

    Article  PubMed  Google Scholar 

  12. Korst R, Humphrey C. Complete lobar collapse following pulmonary lobectomy. Its incidence, predisposing factors, and clinical ramifications. Chest. 1997;111(5):1285–9.

    Article  CAS  PubMed  Google Scholar 

  13. Simonsen D, Søgaard M, Bozi I, Horsburgh C, Thomsen R. Risk factors for postoperative pneumonia after lung cancer surgery and impact of pneumonia on survival. Respir Med. 2015;109(10):1340–6.

    Article  PubMed  Google Scholar 

  14. Dulu A, Pastores S, Park B, Riedel E, Rusch V, Halpern N. Prevalence and mortality of acute lung injury and ARDS after lung resection. Chest. 2006;130(1):73–8.

    Article  PubMed  Google Scholar 

  15. Thorpe A, Rodrigues J, Kavanagh J, Batchelor T, Lyen S. Postoperative complications of pulmonary resection. Clin Radiol. 2020;75(11):876.e871–6.

    Article  Google Scholar 

  16. McCool F, Tzelepis G. Dysfunction of the diaphragm. N Engl J Med. 2012;366(10):932–42.

    Article  CAS  PubMed  Google Scholar 

  17. Yu Y, Qian X, Liu C, Zhu C. Effect of high-flow nasal cannula versus conventional oxygen therapy for patients with thoracoscopic lobectomy after extubation. Can Respir J. 2017;2017:7894631.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Ansari B, Hogan M, Collier T, Baddeley R, Scarci M, Coonar A, Bottrill F, Martinez G, Klein A. A randomized controlled trial of high-flow nasal oxygen (optiflow) as part of an enhanced recovery program after lung resection surgery. Ann Thorac Surg. 2016;101(2):459–64.

    Article  PubMed  Google Scholar 

  19. Brainard J, Scott B, Sullivan B, Fernandez-Bustamante A, Piccoli J, Gebbink M, Bartels K. Heated humidified high-flow nasal cannula oxygen after thoracic surgery - a randomized prospective clinical pilot trial. J Crit Care. 2017;40:225–8.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Pennisi M, Bello G, Congedo M, Montini L, Nachira D, Ferretti G, Meacci E, Gualtieri E, Pascale GD, Grieco D, et al. Early nasal high-flow versus venturi mask oxygen therapy after lung resection: a randomized trial. Crit Care. 2019;23(1):68.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rochwerg B, Einav S, Chaudhuri D, Mancebo J, Mauri T, Helviz Y, Goligher E, Jaber S, Ricard J, Rittayamai N, et al. The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline. Intensive Care Med. 2020;46(12):2226–37.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Auriant I, Jallot A, Hervé P, Cerrina J, Ladurie FLR, Fournier J, Lescot B, Parquin F. Noninvasive ventilation reduces mortality in acute respiratory failure following lung resection. Am J Respir Crit Care Med. 2001;164(7):1231–5.

    Article  CAS  PubMed  Google Scholar 

  23. Aguiló R, Togores B, Pons S, Rubí M, Barbé F, Agustí A. Noninvasive ventilatory support after lung resectional surgery. Chest. 1997;112(1):117–21.

    Article  PubMed  Google Scholar 

  24. Perrin C, Jullien V, Vénissac N, Berthier F, Padovani B, Guillot F, Coussement A, Mouroux J. Prophylactic use of noninvasive ventilation in patients undergoing lung resectional surgery. Respir Med. 2007;101(7):1572–8.

    Article  PubMed  Google Scholar 

  25. Liao G, Chen R, He J. Prophylactic use of noninvasive positive pressure ventilation in post-thoracic surgery patients: a prospective randomized control study. J Thorac Dis. 2010;2(4):205–9.

    PubMed  PubMed Central  Google Scholar 

  26. Lorut C, Lefebvre A, Planquette B, Quinquis L, Clavier H, Santelmo N, Hanna H, Bellenot F, Regnard J, Riquet M, et al. Early postoperative prophylactic noninvasive ventilation after major lung resection in COPD patients: a randomized controlled trial. Intensive Care Med. 2014;40(2):220–7.

    Article  PubMed  Google Scholar 

  27. Rochwerg B, Brochard L, Elliott M, Hess D, Hill N, Nava S, Navalesi P, Committee MOTS, Antonelli M, Brozek J, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017;50(2):1602426.

    Article  PubMed  Google Scholar 

  28. Garutti I, Puente-Maestu L, Laso J, Sevilla R, Ferrando A, Frias I, Reyes A, Ojeda E, Gónzalez-Aragoneses F. Comparison of gas exchange after lung resection with a boussignac CPAP or venturi mask. Br J Anaesth. 2014;112(5):929–35.

    Article  CAS  PubMed  Google Scholar 

  29. Puente-Maestú L, López E, Sayas J, Alday E, Planas A, Parise D, Martínez-Borja M, Garutti I. Group Ps: the effect of immediate postoperative boussignac CPAP on adverse pulmonary events after thoracic surgery: a multicentre, randomised controlled trial. Eur J Anaesthesiol. 2021;38(2):164–70.

    Article  PubMed  Google Scholar 

  30. Stéphan F, Barrucand B, Petit P, Rézaiguia-Delclaux S, Médard A, Delannoy B, Cosserant B, Flicoteaux G, Imbert A, Pilorge C, et al. High-flow nasal oxygen vs noninvasive positive airway pressure in hypoxemic patients after cardiothoracic surgery: a randomized clinical trial. JAMA. 2015;313(23):2331–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Scienze dell’ Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Salvatore Lucio Cutuli, Joel Vargas, Simone Carelli, Eloisa Sofia Tanzarella, Gabriele Pintaudi, Domenico Luca Grieco & Gennaro De Pascale

  2. Facoltà di medicina e chirurgia “A. Gemelli”, Università Cattolica del Sacro Cuore, Rome, Italy

    Gennaro De Pascale

Authors
  1. Salvatore Lucio Cutuli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joel Vargas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simone Carelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eloisa Sofia Tanzarella
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gabriele Pintaudi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Domenico Luca Grieco
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gennaro De Pascale
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gennaro De Pascale .

Editor information

Editors and Affiliations

  1. Neurosc, Reprod, Odontostomatol Sc, University of Naples “Federico II”, Naples, Italy

    Giuseppe Servillo

  2. Neurosc, Reprod, Odontostomatol Sc, University of Naples “Federico II”, Naples, Italy

    Maria Vargas

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Cutuli, S.L. et al. (2023). Non-invasive Positive Pressure Ventilation in Patients Undergoing Lung Resection Surgery. In: Servillo, G., Vargas, M. (eds) Non-invasive Mechanical Ventilation in Critical Care, Anesthesiology and Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-031-36510-2_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-36510-2_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-36509-6

  • Online ISBN: 978-3-031-36510-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation