Freynet Anne, Falcoz Pierre-Emmanuel
Department of Thoracic and Cardiovascular Surgery, Jean-Minjoz University Hospital, Besançon, France.
Interact Cardiovasc Thorac Surg. 2008 Dec;7(6):1152-4. doi: 10.1510/icvts.2008.188334. Epub 2008 Sep 22.
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.
根据结构化方案构建了一个最佳证据主题。所探讨的问题是，在接受肺切除手术的患者中，使用与胸部物理治疗（CPT）相关的无创通气（NIV）在预防呼吸并发症方面是否有效。在通过报告检索找到的172篇论文中，有5篇提供了回答该临床问题的最佳证据。给出了这些论文的作者、期刊、出版日期和国家、研究类型、研究组、相关结局和结果。我们得出结论，总体而言，这5项研究均支持将NIV作为CPT的辅助手段，以改善肺切除手术后的结局。事实上，不仅在治疗术后急性呼吸衰竭方面，而且在预防和治疗呼吸并发症（肺不张、肺炎和支气管充血）方面，NIV的作用和益处都已得到证实。因此，目前的证据表明，NIV与急性CPT管理相结合在减少术后并发症和改善患者恢复方面是安全有效的，从而增加了可用医疗护理的选择，并改善了肺切除手术的结局。
