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Noninvasive Ventilation and Perioperative Mortality

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Reducing Mortality in the Perioperative Period

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Abstract

Postoperative pulmonary complications (PPCs) are caused by a variable impairment of respiratory function, whose common responsible are the dysfunction of the abdominal, thoracic, and diaphragmatic muscles, along with reduction in lung parenchyma excursion and derecruitment occurring after anesthesia and surgery. These abnormalities are frequent, following long and high-risk surgical procedures, and may persist for days. Patients affected by any pulmonary abnormality occurring in the postoperative period are at increased risk of developing ventilation perfusion mismatch, hypoxemia, carbon dioxide retention, and respiratory failure. Moreover, PPCs may be associated with prolonged hospital length of stay, long-term poor outcome, and reduced survival rate [1].

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Author information

Authors and Affiliations

  1. Anesthesia and Intensive Care, Via Cesare Battisti 257, 35100, Padova, Italy

    Paolo Feltracco MD

  2. Cardiac Intensive Care Unit, Anesthesiology and Critical Care Medicine Department, AO Città della Salute e della Scienza, Corso Bramante, 88/90, 10126, Torino, Italy

    Daniela Pasero MD

  3. Anestesia e Rianimazione, Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy

    Laura Ruggeri MD

Authors
  1. Paolo Feltracco MD
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  2. Daniela Pasero MD
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  3. Laura Ruggeri MD
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Corresponding author

Correspondence to Laura Ruggeri MD .

Editor information

Editors and Affiliations

  1. Anestesia Rianimazione e Terapia Intensiva, Università Vita-Salute San Raffaele Ospedale San Raffaele, Milan, Italy

    Giovanni Landoni

  2. Anestesia Rianimazione e Terapia Intensiva, Università Vita-Salute San Raffaele Ospedale San Raffaele, Milan, Italy

    Laura Ruggeri

  3. Anestesia Rianimazione e Terapia Intensiva, Università Vita-Salute San Raffaele Ospedale San Raffaele, Milan, Italy

    Alberto Zangrillo

Summary Table

Summary Table

Clinical summary

Technique

Indications

Cautions

Side effects

Dosage

Notes

Noninvasive ventilation

Postoperative acute respiratory failure

Failure of NIV therapy can be considered the worse complication due to the risk of prolonged time to intubation and should be early detected

Major complications (uncommon): barotrauma and hemodynamic effects

Minor complications (common after prolonged use): aspiration risk, arm edema, deep venous thrombosis, discomfort, facial skin lesions, nasal or oral dryness, nasal congestion, and gastric insufflations

Progressive increase of pressure support and PEEP level to relieve dyspnea and improve gas exchange

Optimal duration of NIV trial is unclear

Evidences of survival benefits come from lung resection surgery [16], liver resection surgery [24], solid organ transplantation [26]

  1. NIV noninvasive ventilation, PEEP positive end-expiratory pressure

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Feltracco, P., Pasero, D., Ruggeri, L. (2017). Noninvasive Ventilation and Perioperative Mortality. In: Landoni, G., Ruggeri, L., Zangrillo, A. (eds) Reducing Mortality in the Perioperative Period. Springer, Cham. https://doi.org/10.1007/978-3-319-46696-5_3

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  • DOI: https://doi.org/10.1007/978-3-319-46696-5_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46695-8

  • Online ISBN: 978-3-319-46696-5

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