DUGi

A randomized clinical trial to assess the effectiveness of highflow nasal cannula oxygen therapy combined with intensive respiratory hysiotherapy to solve postoperative atelectasis in patients after lung resection surgery

http://dugi.udg.edu/item/http:@@@@hdl.handle.net@@10256@@28466

BACKGROUND: Postoperative atelectasis is one of the most common and clinically relevant complications following lung resection surgery, affecting up to half of patients. It contributes to impaired gas exchange, increased risk of pneumonia and acute respiratory distress syndrome, and prolonged hospitalization. Intensive respiratory physiotherapy is the standard treatment; however, its efficacy may be limited in certain cases. High-flow nasal cannula (HFNC) oxygen therapy has shown potential benefits in improving oxygenation and reducing respiratory effort, though its role in managing postoperative atelectasis remains uncertain. OBJECTIVE: To analyze the effectiveness of high-flow nasal cannula oxygen therapy combined with intensive respiratory physiotherapy compared to only intensive respiratory physiotherapy to solve atelectasis in patients after lung resection. STUDY DESIGN AND PARTICIPANTS: A single-center, single-blind, randomized clinical trial will be enrolled at Hospital Universitari Doctor Josep Trueta (Girona, Spain). A total of 128 adult patients undergoing elective lobectomy and diagnosed with postoperative atelectasis using the Air Test will be randomized (1:1) into two groups: control (physiotherapy only) and intervention (HFNC added to physiotherapy). METHODS: All participants will receive standard intensive respiratory physiotherapy. The intervention group will additionally receive HFNC therapy immediately after surgery. Primary outcome includes resolution of atelectasis, while secondary outcomes include incidence of pneumonia, ARDS, need for invasive ventilation, ICU and hospital stay, and HFNC-related adverse events. Statistical analysis will compare outcomes between groups using univariate, bivariate, and multivariate models. APPLICATIONS: This study aims to determine whether combining HFNC with respiratory physiotherapy offers superior clinical benefits for postoperative lung expansion and recovery, potentially guiding postoperative respiratory care protocols after lung resection

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