Postoperative Continuous Positive Airway Pressure Didn't Prevent Respiratory Complications

Respiratory complications (e.g., hypoxemia, pneumonia) are common after abdominal surgery and are thought to be related to postoperative atelectasis. Although adequate analgesia and incentive spirometry are important to minimize atelectasis, continuous positive airway pressure (CPAP) might be more effective. International investigators randomized nearly 5000 patients who had undergone open abdominal surgery (i.e., not laparoscopic) either to CPAP for at least 4 hours within 4 hours after surgery or to usual care. Most patients underwent either bowel resection or hepatobiliary surgery; very few patients who underwent stomach or esophageal surgery were included in the trial.

Incidence of pneumonia, reintubation, or death at 30 days was similar…