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Master Thesis

Ventilation non invasive prophylactique peropératoire sous sédation en rythmologie

Abstract : Rationale. Usefulness of noninvasive ventilation (NIV) during procedure requiring sedation and analgesia has not been established. Objectives. To evaluate whether NIV reduces the incidence of respiratory events during cardiology electrophysiology laboratory procedures. Patients safety and outcome were also evaluated. Methods. We designed a single centre randomized controlled trial comparing NIV to oxygen therapy (O2). Primary endpoint was a composite criteria, a respiratory event, measured by a computer driven and blinded analysis defined by hypoventilation (absence of breathing cycle during 20 seconds of the CO2 curves) and hypoxia (peripheral oxygen saturation under 90%). Hemodynamic, sedation, patient safety (composites scores of major or minor events), and outcome at day 7 were also assessed. Measurements and Main Results. Among the 195 patients randomized, respiratory events happened in 89 of 98 patients in the NIV group (94.7%, [88, 98]) and in 69 of 97 in the O2 group (73.4%, [63, 82]), P<0.001. Hypoxia occurred in 40 (42%, [32, 52]) in the NIV group and in 33 (34 %, [25, 45]) in the O2 group, P=0.298. Hypoventilation happened in 83 patients (92.2%, [85.4, 97]) of the NIV group versus 65 (69.9 %, [59, 79]) of the O2 group, P<0.001. Hemodynamic variables, sedation, major or minor safety events and patient outcome were not different in both group. Conclusion. Among patient receiving NIV in the operatory theater, respiratory event was more frequent without a safety impairment or outcomes improvement. These results does not support the routine use of NIV intraoperatively.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03505770
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Submitted on : Friday, December 31, 2021 - 4:11:36 PM
Last modification on : Monday, January 3, 2022 - 3:30:28 AM

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  • HAL Id : dumas-03505770, version 1

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Valentin Sylvain Pasquier. Ventilation non invasive prophylactique peropératoire sous sédation en rythmologie. Médecine humaine et pathologie. 2020. ⟨dumas-03505770⟩

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