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Critical Care and Peri-operative Medicine Research Group

Postoperative Pulmonary Complications

One in six patients suffer some form of complication after surgery.


Postoperative complications are associated with reduced long-term survivalSome of the most frequent and serious postoperative complications involve the respiratory system, including atelectasis (lung collapse), pneumonia (infection of the lung) and respiratory failure requiring mechanical ventilation. Our research group is interested in understanding the pathophysiological mechanisms underlying respiratory disease after surgery and investigating interventions to prevent and/or treat postoperative pulmonary complications.

We conducted an international clinical effectiveness trial of Continuous Positive Airway Pressure (PRISM) given routinely after major abdominal surgery, which demonstrated no impact on patient outcomes. We subsequently conducted a systematic review and meta-analysis of published evidence of all forms of non-invasive respiratory support after surgery and found limited evidence to support the routine use of high flow nasal oxygen or non-invasive ventilation after surgery. Further clinical trials are needed to determine whether these treatment modalities could be used to prevent postoperative pulmonary complications.


Prevention of Respiratory Insufficiency after Surgical Management (PRISM) trial

To determine whether early postoperative continuous positive airway pressure (CPAP) reduces the incidence of subsequent respiratory complications and improves one year survival following major intra-peritoneal surgery.

Protocol: PRISM protocol v1.6 10th April 2017 [PDF 748KB]

To find out more information, please check out the PRISM website and read the PRISM trial report in The Lancet Respiratory Medicine.

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