Noninvasive Ventilation After Thoracoabdominal Aortic Surgery: A Pilot Randomized Controlled Trial

Objective To assess the beneficial effects of noninvasive ventilation in treating postoperative pulmonary complications in patients undergoing thoracoabdominal aortic aneurysm (TAAA) open repair surgery. Design Randomized controlled trial. Setting University tertiary-care hospital. Participants Forty patients who underwent elective TAAA open repair. Interventions Patients were randomized to the “noninvasive ventilation” group, receiving 2-hour cycles of noninvasive ventilation every 8 hours for at least 3 days in addition to the best available postoperative treatment currently in use at the authors’ institution versus the “standard” group, not receiving noninvasive ventilation treatment Measurements and Main Results The primary outcome of clinical worsening, described as a composite outcome of need for therapeutic noninvasive ventilation, need for mechanical ventilation owing to respiratory causes, need for intensive care unit admission owing to respiratory causes, and in-hospital mortality, occurred in 2 (11%) patients in the noninvasive ventilation group versus 12 (57%) in the standard group (p = 0.002; relative risk 0.18; 95% confidence interval 0.047-0.72). Conclusion Noninvasive ventilation is a promising, affordable, and easy-to-use tool to prevent postoperative respiratory complications after TAAA open surgical repair.