Postoperative spontaneous breathing with CPAP to normalize late postoperative oxygenation

Continuous Positive Airway Pressure for Treatment of Respiratory Complications After Abdominal Surgery

“…17,46,48,49 Overall, the addition of CPAP to standard treatment was associated with a reduction of atelectasis with a risk ratio of 0.25 (95% CI, 0.03-0.42), with a corresponding NNTB of 7.3 (95% CI, 4.4 -64.5; Fig. 4).…”

“…In the trial carried out by Denehy et al, 17 [17][18][19][47][48][49][50][51] and through the endotracheal tube in 1 study. 46 Descriptive data of the populations included in the selected trials are summarized in Table 2. Table 3 shows the methodological quality of the 9 trials.…”

The Scientific Basis for Postoperative Respiratory Care

“…68 The reported advantage of CPAP was that the lung volume facing the most drastic change postoperatively, functional residual capacity, could be restored passively without patient cooperation. That is to say, the application of a CPAP mask increases end-expiratory lung volume without deep breathing and might be associated with less pain and discomfort.…”

“…36,38 Nine studies have evaluated the use of CPAP to prevent PPCs in patients following upper abdominal surgery. 36,38,[68][69][70][71][72][73][74] As with incentive spirometry, the methodological differences in study design, outcomes, and comparators make comparisons difficult. All 9 were randomized trials, but the differences in equipment precluded blinding.…”

“…74 The remaining 8 trials did not demonstrate a difference in the rate of PPC. 36,38,[68][69][70][71][72][73] This finding is in part due to the small number of subjects in each trial, potentially resulting in failure to demonstrate differences because the studies were underpowered. The Squadrone study also demonstrated a reduction in the rate of postoperative pneumonia in the group receiving CPAP.…”