Assessment of preoperative noninvasive ventilation before lung cancer surgery: The preOVNI randomized controlled study

• Published in: The Journal of thoracic and cardiovascular surgery Vol. 160; no. 4; pp. 1050 - 1059.e3
• Main Authors: Paleiron, Nicolas, Grassin, Frédéric, Lancelin, Christophe, Tromeur, Cécile, Margery, Jacques, Natale, Claudia, Couturaud, Francis, Gut-Gobert, Christophe, Barnier, Aude, Noël-Savina, Elise, Bazire, Amélie, Payet, Annabelle, Berard, Henri, Andre, Michel, Vaylet, Fabien, Vinas, Florent, Chouaïd, Christos, Venissac, Nicolas, Donzel-Raynaud, Christine, RAUT, Yvonnick, Salley, Nicolas, Corre, Romain, Kerjouan, Mallorie, Cuvelier, Antoine, Gounane, Cherifa, Blandin, Sonia, Falchero, Lionel, Le Treut, Jacques, Aze, Olivier, Gagnadoux, Frédéric, Trzepizur, Wojciech, Vergnenegre, Alain, Egenod, Thomas, Tiffet, Olivier, Parietti, Eric
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2020
• Subjects: Animal biology; Cellular Biology; Food and Nutrition; Life Sciences; lung cancer surgery; noninvasive ventilation; Pharmaceutical sciences; postoperative complications; randomized controlled trial; AHI; TLco/AV; NSCLC; CI; noninvasive ventilation; ITT; lung cancer surgery; randomized controlled trial; PaO2; SD; FVC; postoperative complications; FEV1; NIV; COPD
• ISSN: 0022-5223; 1097-685X
• DOI: 10.1016/j.jtcvs.2019.09.193

The preOVNI study was a randomized, controlled, open-label study that investigated whether preoperative noninvasive ventilation (NIV) could reduce postoperative complications after lung cancer surgery. Adult patients with planned lung cancer resection and with at least 1 cardiac or respiratory comorbidity were included and randomly assigned to preoperative NIV (at least 7 days and 4 h/day) or no NIV. The primary endpoint was the rate of postoperative protocol-defined complications. Three hundred patients were included. In the NIV group, the median NIV duration was 8 days. No difference of postoperative complication rates was evidenced: 42.6% in NIV group and 44.8% in no-NIV group (P = .75). The rate of pneumonia was greater in no-NIV group compared with the NIV group, but statistical significance was not achieved (28.0 vs 37.7%, respectively; P = .08). The type of surgery (open or minimally invasive) did not impact these results after multivariable analysis. No benefit was evidenced for preoperative NIV before lung cancer surgery. Further studies should determine the optimal perioperative management to decrease the rate of postoperative complications. The preOVNI study. The preOVNI study was a randomized controlled study evaluating preoperative bilevel positive airway pressure (BPAP) before lung cancer surgery; 300 patients were 1:1 randomized. There was no difference in terms of postoperative complications between the two groups. COPD, Chronic obstructive pulmonary disease; CO, carbon monoxide; R, randomization. [Display omitted]