Impact of non-invasive ventilation before and after cardiac surgery for preventing cardiac and pulmonary complications: a clinical randomized trial.

IF 9.5 1区医学 Q1 CRITICAL CARE MEDICINE

Chest Pub Date : 2025-02-19 DOI:10.1016/j.chest.2025.02.010

Marion Goret, Kevin Pluchon, Raphaël Le Mao, Ali Badra, Jean-Ferréol Oilleau, Yohann Morvan, Marc Beaumont, Gwenaëlle Desanglois, Marie Guegan, Aude Barnier, Christophe Gut-Gobert, Cécile Tromeur, Christophe Leroyer, Jean-Noël Choplain, Ahmed Khalifa, Eric Bezon, Francis Couturaud

{"title":"Impact of non-invasive ventilation before and after cardiac surgery for preventing cardiac and pulmonary complications: a clinical randomized trial.","authors":"Marion Goret, Kevin Pluchon, Raphaël Le Mao, Ali Badra, Jean-Ferréol Oilleau, Yohann Morvan, Marc Beaumont, Gwenaëlle Desanglois, Marie Guegan, Aude Barnier, Christophe Gut-Gobert, Cécile Tromeur, Christophe Leroyer, Jean-Noël Choplain, Ahmed Khalifa, Eric Bezon, Francis Couturaud","doi":"10.1016/j.chest.2025.02.010","DOIUrl":null,"url":null,"abstract":"Background: The immediate postoperative period following heart surgery poses a substantial risk of life-threatening complications notably acute pulmonary and cardiac failure. Non-invasive ventilation (NIV) use may reduce the incidence of pulmonary and/or heart failure.Research question: Is the use of NIV before and after cardiac surgery associated with a lower rate of acute pulmonary and heart failure in patients at risk for post-operative complications?Study design and methods: We designed a prospective, randomized, monocentric trial comparing pre- and post-operative NIV in cardiac surgery to standard care. Adult patients classified at risk of post-operative cardiac or pulmonary failure were allocated to receive NIV for five days before and five days after surgery in addition to usual care versus usual care alone. The primary outcome was the composite of predefined and adjudicated cardio-respiratory failure at one month after cardiac surgery.Results: Two hundred and sixteen patients were included. During the one-month follow-up period after surgery, the composite outcome occurred in 59/107 (55.1%) patients in the NIV group and in 87/109 (79.8%) patients in the No-NIV group (RR 0.69 95%CI [0.57-0.84]; p<0.001). The benefit was persistent at three months. There was no difference between the two groups in terms of intubation need and length of hospital stay in cardiac and pulmonary surgery intensive care unit and in cardiac and pulmonary surgery unit.Interpretation: The use of NIV before and after cardiac surgery reduces the rate of cardiopulmonary failure after high-risk cardiac surgery.","PeriodicalId":9782,"journal":{"name":"Chest","volume":" ","pages":""},"PeriodicalIF":9.5000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chest","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.chest.2025.02.010","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The immediate postoperative period following heart surgery poses a substantial risk of life-threatening complications notably acute pulmonary and cardiac failure. Non-invasive ventilation (NIV) use may reduce the incidence of pulmonary and/or heart failure.

Research question: Is the use of NIV before and after cardiac surgery associated with a lower rate of acute pulmonary and heart failure in patients at risk for post-operative complications?

Study design and methods: We designed a prospective, randomized, monocentric trial comparing pre- and post-operative NIV in cardiac surgery to standard care. Adult patients classified at risk of post-operative cardiac or pulmonary failure were allocated to receive NIV for five days before and five days after surgery in addition to usual care versus usual care alone. The primary outcome was the composite of predefined and adjudicated cardio-respiratory failure at one month after cardiac surgery.

Results: Two hundred and sixteen patients were included. During the one-month follow-up period after surgery, the composite outcome occurred in 59/107 (55.1%) patients in the NIV group and in 87/109 (79.8%) patients in the No-NIV group (RR 0.69 95%CI [0.57-0.84]; p<0.001). The benefit was persistent at three months. There was no difference between the two groups in terms of intubation need and length of hospital stay in cardiac and pulmonary surgery intensive care unit and in cardiac and pulmonary surgery unit.

Interpretation: The use of NIV before and after cardiac surgery reduces the rate of cardiopulmonary failure after high-risk cardiac surgery.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Chest 医学-呼吸系统

CiteScore

13.70

自引率

3.10%

发文量

3369

审稿时长

15 days

期刊介绍： At CHEST, our mission is to revolutionize patient care through the collaboration of multidisciplinary clinicians in the fields of pulmonary, critical care, and sleep medicine. We achieve this by publishing cutting-edge clinical research that addresses current challenges and brings forth future advancements. To enhance understanding in a rapidly evolving field, CHEST also features review articles, commentaries, and facilitates discussions on emerging controversies. We place great emphasis on scientific rigor, employing a rigorous peer review process, and ensuring all accepted content is published online within two weeks.