Non-invasive ventilation in the recovery room for-post-operative respiratory failure: a feasibility study

Background. Non-invasive ventilation (NIV) has become a standard of care in acute respiratory failure. However, little data is available on its usefulness in recovery ward patients after general surgery. The present study aimed to document the feasibility of implementing 1, in this setting, and its impact on lung function. Methods: During a 12-month period, all adult patients who underwent elective general surgical procedures under general anaesthesia during weekdays, were transferred to the recovery ward after extubation, and those who required NW were included in this prospective observational study. NIV was applied with a bilevel device (VPAP 11 ST, ResMed, North Ryde, Australia). Results: 4622 patients were admitted to the recovery ward, 83 of Whom needed NIV. NIV increased pH (7.38 +/- .06 vs 7.30 +/- .05), reduced PaCO2 (7.38 +/- .06 vs 7.30 +/- .05) in hypercapnic patients (44 +/- 9 vs 55 +/- 10 mm Hg), and increased PaO2 in non-hypercapnic patients (80 +/- 10 vs 70 +/- 11 mm Hg). No complications attributable to NIV. occurred. Most patients improved after 1-2 NW trials, and all were transferred to the ward the same day. Conclusions. In recovery ward patients after general surgery, NIV is seldom required. When applied, NW seems to exert favourable effects on lung function. NIV can be safely implemented with a bilevel device in a recovery ward not accustomed to the use of ICU ventilators. The cost-effectiveness of its systematic use in this setting should be assessed.