CPAP may not prevent pneumonia, re-intubation, and death after major abdominal surgery: LANCET
Recent research published in The Lancet Journal has revealed that continuous positive airway pressure (CPAP) did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery.
Respiratory complications are an important cause of postoperative morbidity. Therefore, Rupert Pearse and colleagues from the PRISM trial group aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.
The PRISM trial was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care.
Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP.
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