Prophylactic Use of Non-invasive Ventilation After Abdominal and Thoracic Surgery

Tüm cerrahi giri?imler kaçınılmaz olarak bazı solunumsal deği?ikliklere sebep olur. Postoperatif akciğer komplikasyonları hastanede kalım süresi, mortalite ve morbiditeyi arttırırlar ve hala önemli klinik pratik sorunlardır. Bugünlerde, non-invazif ventilasyon kullanımı sıktır ve bir kullanımı da postoperatif akciğer komplikasyonları önlemektir. Toraks ve karın cerrahileri akciğer komplikasyonları açısından yüksek riske sahiptirler. Bunun için, karın ve toraks cerrahisinde koruyucu non-invazif ventilasyonun sonuçlarını incelemek için bir sistematik derleme sunmayı amaçladık

Non-invazif Ventilasyonun Abdominal ve Torasik Cerrahi Sonrası Profilaktik Kullanımı

All types of surgeries inevitably cause some sort of respiratory alterations. Postoperative pulmonary complications increase hospital stay, morbidity and mortality and are still signiŞ cant problems in clinical practice. Nowadays, non-invasive ventilation is in common use and one of its uses is to prevent postoperative pulmonary complications. Thoracic and abdominal surgeries have high risks for pulmonary complications. Thus, we aimed to present a systematic review to analyze the results of prophylactic non-invasive ventilation use after abdominal and thoracic surgeries


1. Özcan Ergin P, Noninvazif Ventilasyon. In: Dikmen Y, editör. Mekanik Ventilasyon, 1st ed. İstanbul: Güneş Kitabevleri; 2012:107–14.

2. Hillberg RE, Johnson DC. Noninvasive ventilation. New Engl J Med 1997;337:1746–52.

3. Rabatin JT, Gay PC. Noninvasive ventilation. Mayo Clin Proc 1999;74:817–20.

4. Tobias JD. Noninvasive ventilation using bilevel positive airway pressure to treat impending respiratory failure in the postanesthesia care unit. J Clin Anesth 2000;12:409–12.

5. Jaber S, Chanques G, Jung B. Postoperative noninvasive ventilation. Anesthesiology 2010;112:453–61.

6. Cereda M, Neligan Patrick J, Reed Amy J. Noninvasive respiratory support in the perioperative period. Current Opinion in Anaesthesiology 2013;26:134–40.

7. Vignaux L, Vargas F, Roeseler J, et al. Patient-ventilator asynchrony during noninvasive ventilation for acute respiratory failure: A multicenter study. Intensive Care Med 2009;35:840–6.

8. Vignaux L, Tassaux D, Carteaux G, et al. Performance of noninvasive ventilation algorithms on ICU ventilators during pressure support: A clinical study. Intensive Care Med 2010;36:2053–9.

9. Certaux G, Lyazidi A, Cordoba-Izqierdo A, et al. Patient ventilator asynchrony during noninvasive ventilation: A bench and clinical study. Chest 2012;142:367–76.

10. Keenan SP, Sinuff T, Burns KE, et al. Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ 2011;183:195–214.

11. Rennotte MT, Baele P, Aubert G, et al. Nasal continuous positive airway pressure in the perioperative management of patients with obstructive sleep apnea submitted to surgery. Chest 1995;107:367–74.

12. Adasenya AO, Lee W, Greilich NB, et al. perioperative management of obstructive sleep apnea. Chest 2010;138:1489–98.

13. Ferrer M, Esquinas A, Arancibia F, et al. Noninvasive ventilation during persistent weaning failure: a randomized controlled trial. Am J Respir Crit Care Med 2003;168:70–6.

14. Chiumello D, Chevallard G, Gregoretti C. Non-invasive ventilation in postoperative patients: A systematic review. Intensive Care Medicine 2011;37:918–29.

15. Gunnarsson L, Tokics L, Gustavsson H, et al. Infl uence of age on atelectasis formation and gas exchange impairment during general anaesthesia. Br J Anaesth 1991;66:423–32.

16. Özyilmaz E, Kaya A, Postoperatif hastada gelisen solunum yetmezliginde noninvazif mekanik ventilasyonun yeri. Available from: folder/2012–02/html/2012–60–02–185–192.htm

17. Daley M. D, Norman P. H, Colmenares M. E, et al. Hypoxaemia in adults in the post-anaesthesia care unit. Canadian Journal of Anaesthesia 1991;38:740–6.

18. Nicholau D. Th e Postanesthesia Care Unit. In: Miller RD, editor. Miller’s Anesthesia Volume 2, 7th ed. Philadelphia: Elsevier; 2010:2707–28.

19. Canet J, Gallart L, Gomar C, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology 2010;113:1338–50.

20. Hedenstierna G, Edmark L. Th e eff ects of anaesthesia and muscle paralysis on the respiratory system. Intenseive Care Med 2005;31:1327–35.

21. Rusca M, Proietti S, Schnyder P, et al. Prevention of atelectasis formation during induction of general anesthesia. Anesth Analg 2003;97:1835–9.

22. Benoit Z, Wicky S, Fischer JF, et al. Th e eff ect of increased FiO2 before tracheal extubation on postoperative atelectasis. Anesth Analg 2002;95:1777–81.

23. Th omas JA, McIntosh JM. Are incentive spirometer, intermittent positive pressure breathing, and deep breathing exercises eff ective in the prevention of postoperative pulmonary complications aft er upper abdominal surgery? A systematic overview and meta-analysis. Phys Th er 1994n; 74:3–10.

24. Cabrini L, Plumari VP, Landoni G, et al. Intraoperative prophylactic and threpeutic non-invasive ventilation: a systematic review. British Journal of Anaesthesia 2014;112:638–47.

25. Jaber S, Delay J, Sebbane M, et al. Outcomes of patients with acute respiratory failure aft er abdominal surgery treated with noninvasive positive-pressure ventilation. Chest 2005;128:2688–95.

26. Stock M, Downs J, Gauer P, et al. Prevention of postoperative pulmonary complications with CPAP, incentive spirometer, and conservative therapy. Chest 1985;87:151–7.

27. Anderes C, Anderes U, Gasser D, et al. Postoperative spontaneous breathing with CPAP to normalize late postoperative oxygenation. Intensive Care Med 1979;5:15–21.

28. Bohner H, Kindgen-Milles D, Grust A, et al. Prophylactic nasal continuous positive airway pressure aft er major vascular surgery: results of a prospective randomized trial. Langenbecks Arch Surg 2002;387:21–6.

29. Carlsson C, Sonden B, Th ylen U. Can postoperative continuous positive airway pressure (CPAP) prevent pulmonary complications aft er abdominal surgery? Intensive Care Med 1981;7:225–9.

30. Denehy L, Carroll S, Ntoumenopoulos G, et al. A randomized controlled trial comparing periodic mask CPAP with physiotherapy aft er abdominal surgery. Physiother Res Int 2001;6:236–50.

31. Lindner KH, Lotz P, Ahnefeld FW. Continuous positive airway pressure eff ect on functional residual capacity, vital capacity and its subdivisions. Chest 1987;92:66–70.

32. Ricksten SE, Bengtsson A, Soderberg C, et al. Eff ects of periodic positive airway pressure by mask on postoperative pulmonary function. Chest 1986;89:774–81.

33. Squadrone V, Coha M, Cerutti E, et al. Continuous positive airway pressure for treatment of postoperative hypoxemia: A randomized controlled trial. JAMA 2005;293:589–95.

34. Aguilo R, Togores B, Pons S, et al. Noninvasive ventilatory support aft er lung resectional surgery. Chest 1997;112:117–21.

35. Perrin C, Jullien V, Vénissac N, et al. Prophylactic use of noninvasive ventilation in patients undergoing lung resectional surgery. Respir Med 2007;101:1572–8.

36. Fagevik Olsen M, Wennberg E, Johnsson E, et al. Randomized Clinical study of prevention of pulmonary complications aft er thoraco-abdominal resection by two diff erent breathing techniques. Br J Surg 2002;89:1228–34.

37. Kingden-Milles D, Muller E, Buhl R, et al. Nasal-continious airway pressure reduces pulmonary morbidity and length of hospital stay following thoraco-abdominal aortic surgery. Chest 2005;28:821–8.

38. Shander A, Fleisher LA, Barie PS, et al. Clinical and economical burden of postoperative pulmonary complications: patient safety summit on defi nition, risk reducing interventions, and preventative strategies. Crit Care Med 2011;39:216–72.

39. Eichenberger A, Prilotti S, Wicky S, et al. Morbid obesity ad postoperative pulmonary atelectasis: an underestimated problem. Anesth Analg 1999;95:1788–92.

40. Xue FS, Li BW, Zhang GS, et al. Th e infl uence of surgical sites on early postoperative hypoxemia in adults undergoing elective surgery. Anesth Analg 1999;88:3–19.

41. Başoğlu O, Bacakoğlu F, Ersin S, et al. Üst karin cerrahisinde postoperatif solunumsal komplikasyon riskinin preoperative parametrelerle iliskisi. Toraks Dergisi 2000;2:17–22.

Kaynak Göster