Continuous positive airway pressure after major abdominal surgery: an independent discussion of the Prevention of Respiratory Insufficiency after Surgical Management trial

Sharon Einav; Ronelle Mouton

doi:10.1016/j.bja.2021.05.012

Continuous positive airway pressure after major abdominal surgery: an independent discussion of the Prevention of Respiratory Insufficiency after Surgical Management trial

Sharon Einav^*, Ronelle Mouton^*

^*Corresponding author for this work

Bristol Medical School (THS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

2 Citations (Scopus)

Abstract

Postoperative respiratory complications frequently lead to respiratory failure requiring mechanical ventilation and death,1 particularly after major abdominal surgery. Noninvasive respiratory support using continuous positive airway pressure (CPAP) is safe and reliable and may improve outcomes in patients who develop respiratory failure after major surgery. Small trials suggest that CPAP applied early after major surgery may reduce respiratory complications. The Prevention of Respiratory Insufficiency after Surgical Management (PRISM) trial investigated whether preventative CPAP administered within 4 h after major open abdominal surgery reduces the incidence of pneumonia, tracheal re-intubation, and/or 30 day mortality. Here, we consider the findings and inferential reproducibility of the PRISM trial using a structured independent discussion.

Original language	English
Pages (from-to)	310-315
Number of pages	6
Journal	British Journal of Anaesthesia
Volume	127
Issue number	2
Early online date	1 Jul 2021
DOIs	https://doi.org/10.1016/j.bja.2021.05.012
Publication status	Published - 1 Aug 2021

Bibliographical note

Funding Information:
SE chairs the systematic review group of the European Society of Intensive Care (ESICM), is a Cochrane editor, a member of the Data Use Committee of the American Society of Anesthesiologists, has lectured and chaired panels on noninvasive ventilation (unsupported), has patents with Medtronic and has received funding from Zoll, Astra-Zeneca, Artisanpharma, Eisai and from the Israel Ministry of Health, National Institute for Health Policy Research, and Hebrew University Research and Development authority.
RM is the Chair of the Vascular Anaesthesia Society of Great Britain & Ireland (VASGBI), a member of the Chief Investigator scheme of the Perioperative Medicine Clinical Trials Network (POMCTN) and holds/has held grants from the National institute for Academic Anaesthesia (NIAA); the National Institute for Health Research (NIHR) and the David Telling Charitable Trust.

Publisher Copyright:
Crown Copyright © 2021 Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. All rights reserved.

Keywords

anaesthesia
continuous positive airway pressure
postoperative complications
randomised controlled trial
surgery

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title = "Continuous positive airway pressure after major abdominal surgery: an independent discussion of the Prevention of Respiratory Insufficiency after Surgical Management trial",

abstract = "Postoperative respiratory complications frequently lead to respiratory failure requiring mechanical ventilation and death,1 particularly after major abdominal surgery. Noninvasive respiratory support using continuous positive airway pressure (CPAP) is safe and reliable and may improve outcomes in patients who develop respiratory failure after major surgery. Small trials suggest that CPAP applied early after major surgery may reduce respiratory complications. The Prevention of Respiratory Insufficiency after Surgical Management (PRISM) trial investigated whether preventative CPAP administered within 4 h after major open abdominal surgery reduces the incidence of pneumonia, tracheal re-intubation, and/or 30 day mortality. Here, we consider the findings and inferential reproducibility of the PRISM trial using a structured independent discussion.",

keywords = "anaesthesia, continuous positive airway pressure, postoperative complications, randomised controlled trial, surgery",

author = "Sharon Einav and Ronelle Mouton",

note = "Funding Information: SE chairs the systematic review group of the European Society of Intensive Care (ESICM), is a Cochrane editor, a member of the Data Use Committee of the American Society of Anesthesiologists, has lectured and chaired panels on noninvasive ventilation (unsupported), has patents with Medtronic and has received funding from Zoll, Astra-Zeneca, Artisanpharma, Eisai and from the Israel Ministry of Health, National Institute for Health Policy Research, and Hebrew University Research and Development authority. RM is the Chair of the Vascular Anaesthesia Society of Great Britain \& Ireland (VASGBI), a member of the Chief Investigator scheme of the Perioperative Medicine Clinical Trials Network (POMCTN) and holds/has held grants from the National institute for Academic Anaesthesia (NIAA); the National Institute for Health Research (NIHR) and the David Telling Charitable Trust. Publisher Copyright: Crown Copyright {\textcopyright} 2021 Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. All rights reserved.",

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Continuous positive airway pressure after major abdominal surgery: an independent discussion of the Prevention of Respiratory Insufficiency after Surgical Management trial. / Einav, Sharon; Mouton, Ronelle.
In: British Journal of Anaesthesia, Vol. 127, No. 2, 01.08.2021, p. 310-315.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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N2 - Postoperative respiratory complications frequently lead to respiratory failure requiring mechanical ventilation and death,1 particularly after major abdominal surgery. Noninvasive respiratory support using continuous positive airway pressure (CPAP) is safe and reliable and may improve outcomes in patients who develop respiratory failure after major surgery. Small trials suggest that CPAP applied early after major surgery may reduce respiratory complications. The Prevention of Respiratory Insufficiency after Surgical Management (PRISM) trial investigated whether preventative CPAP administered within 4 h after major open abdominal surgery reduces the incidence of pneumonia, tracheal re-intubation, and/or 30 day mortality. Here, we consider the findings and inferential reproducibility of the PRISM trial using a structured independent discussion.

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ER -

Continuous positive airway pressure after major abdominal surgery: an independent discussion of the Prevention of Respiratory Insufficiency after Surgical Management trial

Abstract

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Keywords

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