Noninvasive Ventilation on Tracheal Reintubation After Abdominal Surgery
Jaber 2016 trial design and results
Design
Multicentre randomised clinical trial
Treatment
Non-invasive ventilation
Control
Standard oxygen therapy
Population
293 patients with hypoxaemic respiratory failure following abdominal surgery, mean age 63.4, 224 men
Follow-up
30 days
Primary endpoint
Tracheal reintubation within 7 days
Result
Reintubation within 7 days occurred in 49 of 148 (33.1%) with non-invasive ventilation versus 66 of 145 (45.5%) with standard oxygen — absolute difference -12.4 percentage points (95% CI -23.5 to -1.3, p=0.03).
Among patients with hypoxemic respiratory failure following abdominal surgery, use of NIV compared with standard oxygen therapy reduced the risk of tracheal reintubation within 7 days. These findings support use of NIV in this setting.
The trial authors, in the published abstract
How it has aged
One of the clearer positive results for non-invasive ventilation in hypoxaemic failure, and the population explains why: post-operative atelectasis and abdominal splinting are a mechanical problem that positive pressure directly addresses, unlike the parenchymal disease in FLORALI.
Publications
Effect of Noninvasive Ventilation on Tracheal Reintubation Among Patients With Hypoxemic Respiratory Failure Following Abdominal Surgery: A Randomized Clinical Trial
Jaber S, Lescot T, Futier E, et al. Effect of Noninvasive Ventilation on Tracheal Reintubation Among Patients With Hypoxemic Respiratory Failure Following Abdominal Surgery: A Randomized Clinical Trial. JAMA 2016 Apr 5;315(13):1345-53.
Reintubation within 7 days reduced from 45.5% to 33.1%
Population had a mechanical, post-operative cause of hypoxaemia