التفاصيل البيبلوغرافية
| العنوان: |
Non-invasive positive airway pressure thErapy to reduce postoperative lung complications following upper abdominal surgery (NIPPER PLUS): a pilot randomised control trial |
| المؤلفون: |
Lockstone, J, Parry, SM, Denehy, L, Iain Robertson, Story, D, Ianthe Boden |
| سنة النشر: |
2022 |
| مصطلحات موضوعية: |
Anaesthesiology, Surgery, Physiotherapy, abdominal surgery, noninvasive ventilation, postoperative care, postoperative complications |
| الوصف: |
Objectives: Postoperative pulmonary complications (PPC) are a common serious complication following upper abdominal surgery. Postoperatively, physiotherapy-led non-invasive ventilation (NIV) may be a promising method to reduce PPC incidence. The objectives of this pilot trial were to examine preliminary effectiveness, feasibility and safety of additional intermittent physiotherapy-led NIV compared to continuous high-flow nasal cannula oxygen therapy (HFNC) alone. Design: Single-centre, assessor-blinded, parallel-group, pilot randomised control trial. Setting: Primary-referral hospital in Australia. Participants: 130 high-risk patients undergoing upper abdominal surgery. Interventions: Continuous HFNC for 48-hours following surgical extubation, or HFNC plus five 30-minute physiotherapy-led NIV sessions. Outcomes PPC incidence, trial feasibility and safety. Results: PPC incidence was similar between groups (HFNC alone 12/65 (18%) vs HFNC plus NIV 10/64 (16%) adjusted HR 0.95; 95% CI 0.40-2.29). Delivery of HFNC as per-protocol was achieved in 81% (n=105) of all participants. Physiotherapy-led NIV initiated within four-hours of surgical extubation was achieved in 81% (n=52) of intervention group participants, with a mean 4.2 (SD 1.3) total number of NIV sessions delivered in the first two postoperative days. NIV was delivered as per-protocol in 52% of this cohort. Two episodes of severe hypotension during NIV requiring medical intervention were reported. Conclusion: Delivery of continuous HFNC was feasible. Delivery of NIV within four-hours of extubation was achieved and delivered safely with <1% adverse events. The planned NIV intervention of five sessions within two postoperative days was not feasible. The results of this pilot study have informed the decision not to proceed to a fully powered trial. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
unknown |
| Relation: |
102.100.100/549636; https://figshare.com/articles/journal_contribution/Non-invasive_positive_airway_pressure_thErapy_to_reduce_postoperative_lung_complications_following_upper_abdominal_surgery_NIPPER_PLUS_a_pilot_randomised_control_trial/23009855 |
| الاتاحة: |
https://figshare.com/articles/journal_contribution/Non-invasive_positive_airway_pressure_thErapy_to_reduce_postoperative_lung_complications_following_upper_abdominal_surgery_NIPPER_PLUS_a_pilot_randomised_control_trial/23009855 |
| Rights: |
In Copyright |
| رقم الانضمام: |
edsbas.FC10D01B |
| قاعدة البيانات: |
BASE |