• Hinrich Böhner, Detlef Kindgen-Milles, Andreas Grust, Rolf Buhl, Wolf-Christian Lillotte, Barbara T Müller, Eckhard Müller, Günter Fürst, and Wilhelm Sandmann.
• Department of Vascular Surgery and Kidney Transplantation, Heinrich-Heine University, Moorenstrasse 5, 40225 Düsseldorf, Germany. Boehner@med.uni-duesseldorf.de
• Langenbecks Arch Surg. 2002 Apr 1;387(1):21-6.

BackgroundThe efficacy of nasal continuous positive airway pressure (nCPAP) as a prophylactic method for preventing cardiopulmonary complications after major vascular surgery has not been investigated.Patients/MethodsIn a prospective randomized trial, 204 patients undergoing elective midline laparotomy for vascular surgery were randomized to receive standard therapy ( n=105) or additional prophylactic nCPAP ( n=99) for the first postoperative night. Postoperative oxygenation, incidence of severe cardiac, and pulmonary complications, length of intensive care surveillance and length of total postoperative hospital stay (LOS) were compared.ResultsProphylactic nCPAP significantly reduced the number of patients with severe oxygenation disturbances defined as paO(2) < 70 mmHg with FiO(2) > or = 0.7 (5 versus 17, P=.01). There were no differences with respect to death, cardiac and pulmonary complications, length of intensive care surveillance or LOS.ConclusionProphylactic 12 h nCPAP significantly reduces the occurrence of postoperative oxygenation disturbances but has no effect on cardiac or pulmonary complications, need for intensive care, LOS or mortality after major vascular surgery.

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