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.