Noninvasive ventilation improves the outcome of pulmonary complications after liver resection

Pulmonary complications are associated with increased mortality after liver resection. Although noninvasive ventilation (NIV) has proved to be an effective treatment for respiratory failure after abdominal surgery, including organ transplantation, its efficacy for pulmonary complications following liver resection per se has not been reported. The aim of this retrospective study was to investigate the effects of NIV in patients with postoperative pulmonary complications after liver resection.

A retrospective single center study. Between April 2002 and March 2005, we used NIV in 16 patients who met the criteria for NIV after liver resection: respiratory failure and/or a massive atelectasis (NIV group). We also reviewed data on 10 patients who underwent liver resection from April 1999 to March 2002, and met the criteria for NIV after the operation and received conventional treatment (non-NIV group).

Respiratory-cause mortality was significantly lower in NIV group than in non-NIV group (0.0% vs. 40.0%, p=0.007), and all-cause mortality tended to be lower in NIV group (18.8% vs. 50.0%, p=0.100). After NIV treatment for 24 hours, the PaO(2)/FiO(2) ratio and PaCO(2) were improved significantly but no significant improvement was noted in non-NIV group. Rate of reintubation was significantly lower in NIV group (12.5% vs. 50.0%, p=0.040). NIV was tolerated in all 16 NIV group patients, and no severe NIV-related complications were observed.

NIV is effective in patients with respiratory failure and/or massive atelectasis after liver resection.