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Does non-invasive ventilation associated with chest physiotherapy improve outcome after lung resection?

Department of Thoracic and Cardiovascular Surgery, Jean-Minjoz University Hospital, Besançon, France

Corresponding author. Department of Thoracic and Cardiovascular Surgery, Hôpital Jean-Minjoz, Boulevard Fleming, 25000 Besançon, France. Tel.: +33-3-81668664; fax: +33-3-81668661.

E-mail address: pierre-emmanuel.falcoz{at}wanadoo.fr (P.-E. Falcoz).

A best evidence topic was constructed according to a structured protocol. The question addressed was whether the use of non-invasive ventilation (NIV) associated with chest physiotherapy (CPT) is effective in preventing respiratory complications in patients undergoing lung resection surgery. Of the 172 papers found using a report search, five presented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. We conclude that, on the whole, the five studies were all in favor of NIV as an adjuvant to CPT for improving outcome after lung resection surgery. Indeed, the interest and benefit has been shown not only in the treatment of postoperative acute respiratory failure, but also in the prevention and treatment of respiratory complications (atelectasis, pneumonia and bronchial congestion). Hence, current evidence shows NIV associated with acute CPT management to be safe and effective in reducing postoperative complications and in improving patient recovery, thus enhancing the choice of available medical care and bettering outcome in lung resection surgery.

Key Words: Non-invasive ventilation; Chest physiotherapy; Lung resection surgery; Respiratory complications