Hernández 2018.
Methods | RCT January 2012 ‐ June 2013 |
|
Participants | 50 patients Patients who had undergone elective lung resection (segmentectomy, lobectomy or pneumonectomy) by posterolateral thoracotomy for lung cancer, lung metastasis and bronchiectasis surgery |
|
Interventions | Intervention: Preoperative period: respiratory rehabilitation 2 weeks before surgery + NIPPV one week before surgery Postoperative period: NIPPV (bi‐level mode) with IPAP 10‐12 cmH2 and an EPAP 4‐5 cmH2 for 30 min every 2 h until 24:00. Later, during the night, it was administered only once from 4:00 to 4:30 am. After this last session, treatment with BiPAP was terminated + chest physiotherapy + 500 mg of nebulized ipratropium bromide diluted in 3 ml of saline every 8 h for the first 3 days Control: Preoperative period: respiratory rehabilitation 2 weeks before surgery Postoperative period: venturi mask with FiO2 40% + 500 mg of nebulized ipratropium bromide diluted in 3 ml of saline every 8 h for the first 3 days |
|
Outcomes | Pulmonary complication Length of hospital stay Spirometric values Arterial blood gases Radiographic findings |
|
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Random number generation |
Allocation concealment (selection bias) | High risk | Both groups were separate according to the use or not of prophylactic BiPAP |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Outcome data were objective |
Incomplete outcome data (attrition bias) All outcomes | Low risk | 50 patients were enrolled and 50 finished the study |
Selective reporting (reporting bias) | Low risk | No evidence of selective reporting |
Other bias | High risk | The study included participants with better respiratory function than the majority of the patients included in other studies. It results in low incidence of clinically significant postoperative complications compared to other analyses |