Effectiveness of prophylactic non-invasive ventilation on respiratory function in the postoperative phase of pediatric cardiac surgery: a randomized controlled trial.
Camilla R S Silva, Lívia B Andrade, Danielle A S X Maux and 2 others
PMID 27706462WHAT IT FOUND
Prophylactic CPAP after pediatric cardiac surgery did not improve most respiratory function measures or shorten hospital and ICU stay.
Peak expiratory flow was higher on postoperative day 1, but the difference did not persist.
Key findings
01The primary respiratory function outcome did not show a consistent benefit. Peak expiratory flow was higher in the CPAP group on postoperative day 1, but not on days 3 or 5, and other respiratory measures did not differ.
02Hospital and ICU length of stay did not differ between groups.
03The CPAP group received CPAP in addition to posture, early ambulation, and cough instructions; the control group received those instructions alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 50 of 62 randomized children completed the study, a 19% loss of follow-up. Follow-up ended on postoperative day 5, which may be too short to detect differences in respiratory recovery. The paper says there are no age-specific reference patterns for these respiratory measures, so small differences are hard to interpret. The CPAP group also received posture, early ambulation, and cough instructions, so any effect of CPAP alone cannot be separated from those measures. The trial included children aged seven to 16 after median sternotomy, so it does not directly show what would happen in younger children or other surgical groups.
The easy way to misread this
Do not read the day-1 peak flow difference as proof that CPAP alone improves recovery. The CPAP group also received posture, early ambulation, and cough instructions, and the difference did not persist on later days.