Preventive and therapeutic noninvasive ventilation in cardiovascular surgery

Cabrini, Luca; Zangrillo, Alberto; Landoni, Giovanni

doi:10.1097/aco.0000000000000148

Cited by 19 publications

(9 citation statements)

References 37 publications

(32 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All of these factors might induce atelectasis, pulmonary infection, decreased lung function, and even varying degrees of hypoxia. 26,27 Cardiac and distal organ complications might be caused by the surgical procedure or systemic inflammatory response syndrome irritated by perioperative factors (e.g., cardiopulmonary bypass or allogenic blood products). 28 Complications can prolong hospital stay and be relevant to a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Noninvasive Ventilation Versus Conventional Care in Patients After Cardiac Surgery

Liu

Shan

Liu

et al. 2020

Journal of Surgical Research

View full text Add to dashboard Cite

Prophylactic noninvasive ventilation Conventional pulmonary care a b s t r a c t Background: Cardiac surgery can be accompanied by postoperative complications, which are associated with increased postoperative morbidity and mortality. Therefore, it is necessary to investigate the effect of prophylactic noninvasive ventilation (NIV) after extubation versus conventional pulmonary care on complications after cardiac surgery. Materials and methods: An electronic search of PubMed, Cochrane Library, Ovid, and EMBASE was conducted to find randomized controlled trials which compared the effect of prophylactic NIV with controlled strategies on complications and which were published before April 2018. Results: Ten studies (1011 patients) were included in the final analysis. The atelectasis rate was 32.6% in the prophylactic-NIV group, which was lower than that in the control group (48.71%). Prophylactic NIV could lower the rate of atelectasis, reintubation, and other respiratory complications (pleural effusion, pneumonia, and hypoxia) (odds ratio ¼ 0.43, 0.33, and 0.45; 95% confidence interval: 0.21-0.88, 0. 13-0.84, 0.27-0.75; P ¼ 0.02, 0.02, and 0.002, respectively). The effect on cardiac and distal organ complications (P ¼ 0.07) and hospital mortality (P ¼ 0.62) might be limited. Conclusions: Prophylactic NIV is associated with a lower rate of postoperative pulmonary complications. The effect on the other complications and hospital mortality might be limited. Further evidence with randomized controlled trials can discern the benefits.

show abstract

Section: Discussionmentioning

confidence: 99%

Prophylactic Noninvasive Ventilation Versus Conventional Care in Patients After Cardiac Surgery

Liu

Shan

Liu

et al. 2020

Journal of Surgical Research

View full text Add to dashboard Cite

show abstract

“…However, its role as a preventive tool remains unclear and is probably limited to high-risk patients. [ 37 ] Finally, Olper et al [ 38 ] suggested that NIV was associated with lower reintubation rate after cardiothoracic surgery. However, the type of disease status was not specific and reported outcomes were not comprehensive in previous meta-analyses.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of noninvasive ventilation in patients after cardiothoracic surgery

Zhu

Huang²,

Dong³

et al. 2016

Medicine

View full text Add to dashboard Cite

Background:Noninvasive ventilation (NIV) is a promising therapeutic strategy after cardiothoracic surgery. This study aimed to meta-analyze the efficacy and safety of NIV as compared to conventional management after cardiothoracic surgery.Methods:PubMed, EMBASE, and Cochrane Library databases were searched for randomized controlled trials (RCTs) comparing NIV with conventional management after cardiothoracic surgery. Relative risk (RR), standard mean difference (SMD), and 95% confidence intervals (CIs) were used to measure the efficacy and safety of NIV using random-effects model. Heterogeneity was evaluated using the Q statistic.Results:This study included 14 RCTs (1740 patients) for the evaluation of efficacy and safety of NIV as compared to conventional management after cardiothoracic surgery. Overall, NIV had minimal effect on the risk of mortality (RR: 0.64; 95% CI: 0.36–1.14; P = 0.127), endotracheal intubation (RR: 0.52; 95% CI: 0.24–1.11; P = 0.090), respiratory (RR: 0.70; 95% CI: 0.47–1.30; P = 0.340), cardiovascular (RR: 0.81; 95% CI: 0.54–1.22; P = 0.306), renal (RR: 0.70; 95% CI: 0.26–1.92; P = 0.491), and other complications (RR: 0.72; 95% CI: 0.38–1.36; P = 0.305), respiratory rate (SMD: −0.10; 95% CI: −1.21–1.01; P = 0.862), heart rate (SMD: −0.27; 95% CI: −0.76–0.22; P = 0.288), PaO2/FiO2 ratio (SMD: 0.34; 95% CI: −0.17−0.85; P = 0.194), PaCO2 (SMD: 0.83; 95% CI: −0.12–1.77; P = 0.087), systolic pressure (SMD: −0.04; 95% CI: −0.25–0.17; P = 0.700), pH (SMD: −0.01; 95% CI: −0.44–0.43; P = 0.974), length of ICU stay (SMD: −0.19; 95% CI: −0.47–0.08; P = 0.171), and hospital stay (SMD: −0.31; 95% CI: −1.00–0.38; P = 0.373). Sensitivity analysis showed that NIV was associated with higher levels of PaO2/FiO2 ratio (SMD: 0.52; 95% CI: 0.00–1.05; P = 0.048) and lower risk of endotracheal intubation (RR: 0.38; 95% CI: 0.22–0.66; P = 0.001).Conclusion:As compared to conventional management, the use of NIV after cardiothoracic surgery improved patient's oxygenation and decreased the need for endotracheal intubation, without significant complications.

show abstract

“…Janus is a novel interface with an original design, allowing its application both before or during the UE without removing the probe 11,12 . So far no clinical study described its efficacy, hence we performed a benchstudy testing its ability to guarantee a PEEP when different probes are inserted through the central hole.…”

Section: Source Of Support: Nilmentioning

confidence: 99%

“…NIV is a wellestablished treatment of acute respiratory failure, with a wide range of application 3,4,[10][11][12] . Several reports demonstrated that NIV can preserve arterial oxygenation during UE, and in particular during risky procedures like FOB or TEE in hypoxemic patients 5,[13][14][15] .…”

Section: Source Of Support: Nilmentioning

confidence: 99%

Continuous Positive Airway Pressure During Upper Endoscopies: A Bench Study on a Novel Device

Cabrini

Savia

Bevilacqua

et al. 2016

Journal of Cardiothoracic and Vascular Anesthesia

Self Cite

View full text Add to dashboard Cite

Preventive and therapeutic noninvasive ventilation in cardiovascular surgery

Cited by 19 publications

References 37 publications

Prophylactic Noninvasive Ventilation Versus Conventional Care in Patients After Cardiac Surgery

Prophylactic Noninvasive Ventilation Versus Conventional Care in Patients After Cardiac Surgery

Efficacy and safety of noninvasive ventilation in patients after cardiothoracic surgery

Continuous Positive Airway Pressure During Upper Endoscopies: A Bench Study on a Novel Device

Contact Info

Product

Resources

About