Non-invasive ventilation in postoperative patients: a systematic review

Area of Science:

• Critical Care Medicine
• Respiratory Medicine
• Surgical Patient Management

Background:

• Postoperative pulmonary complications significantly increase morbidity and mortality.
• Non-invasive ventilation (NIV) is increasingly used in perioperative settings.
• NIV is traditionally applied for conditions like pulmonary edema and respiratory failure.

Purpose of the Study:

• To investigate the application and outcomes of preventive and therapeutic NIV in postsurgical patients.
• To evaluate the role of NIV in reducing postoperative complications.
• To assess the impact of NIV on gas exchange and intubation rates.

Main Methods:

• A systematic review of medical literature databases.
• Inclusion of clinical trials, randomized controlled trials, and meta-analyses.
• Keywords combined various surgical types with NIV and respiratory outcomes.

Main Results:

• Twenty-nine articles involving 2,279 patients were reviewed across multiple surgical types.
• NIV improved arterial blood gases in a majority of prophylactic and therapeutic studies.
• NIV reduced the intubation rate in 11 of 29 studies, but improved overall outcome in only one.

Conclusions:

• NIV shows potential as a prophylactic and therapeutic tool for improving gas exchange in postoperative patients.
• Further randomized trials are necessary to solidify the evidence base for NIV in surgical settings.
• NIV may be considered for respiratory support in the postoperative period.