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Comparative Study
. 2009 Jan;96(1):54-60.
doi: 10.1002/bjs.6307.

Non-invasive ventilation for treatment of postoperative respiratory failure after oesophagectomy

P Michelet  1 , X B D'Journo, F Seinaye, J M Forel, L Papazian, P Thomas
Affiliations
Comparative Study

Non-invasive ventilation for treatment of postoperative respiratory failure after oesophagectomy

P Michelet et al. Br J Surg. 2009 Jan.

Abstract

Background: The aim of this case-control study was to compare the efficacy of non-invasive positive pressure ventilation (NPPV) with that of conventional treatment in patients who develop postoperative acute respiratory failure (ARF) after oesophagectomy.

Methods: Thirty-six consecutive patients with ARF treated by NPPV were matched for diagnosis, age within 5 years, sex, preoperative radiochemotherapy and Charlson co-morbidity index with 36 patients who received conventional treatment (control group).

Results: NPPV was associated with a lower reintubation rate (nine versus 23 patients; P = 0.008), lower frequency of acute respiratory distress syndrome (eight versus 19 patients; P = 0.015), and a reduction in intensive care stay (mean(s.d.) 14(13) versus 22(18) days; P = 0.034). Anastomotic leakage was less common in patients receiving NPPV (two versus ten; P = 0.027). These patients also showed a greater improvement in gas exchange in the first 3 days after onset of ARF (P = 0.013).

Conclusion: The use of NPPV for the treatment of postoperative ARF may decrease the incidence of endotracheal intubation and related complications, without increasing the risk of anastomotic leakage after oesophagectomy.

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