Trial reportEuropean journal of anaesthesiology2025
Continuous positive airway pressure to prevent reintubation in patients recovering from cardiac surgery: A multicentre randomised clinical trial.
Trial report in European journal of anaesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01726140 (CPAP Reduces Hypoxemia After Cardiac Surgery), which is not on this map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
CPAP Reduces Hypoxemia After Cardiac Surgery (CRHACS Trial). A Randomized Controlled Trial
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Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary complications, including atelectasis and reintubation, are common after cardiac surgery and are associated with increased morbidity and mortality. Postoperative continuous positive airway pressure (CPAP) may reduce these risks, but its effectiveness remains uncertain.
objectivesTo assess whether CPAP reduces the need for reintubation in hypoxaemic patients after cardiac surgery, and to evaluate its effect on other postoperative pulmonary complications.
designMulticentre, open-label, randomised clinical trial. The study was prematurely terminated due to funding constraints, leading to an underpowered sample.
settingTen university-affiliated hospitals across Italy. PATIENTS: Adults undergoing cardiac surgery with cardiopulmonary bypass who developed a Pa O 2 /FiO 2 ratio 200 or less within 1 h of extubation. Exclusion criteria included severe COPD, previous mechanical ventilation and lack of consent.
main outcome measuresThe primary endpoint was reintubation within 28 days of surgery. Secondary endpoints included atelectasis, pneumonia, sepsis, mortality and oxygenation.
resultsThe incidence of reintubation was 10.8% (95% confidence interval [CI], 6.52 to 15.15) in the control group and 8.3% (95% CI, 4.51 to 12.16) in the treatment group ( P = 0.3908). In contrast, the occurrence of atelectasis was significantly higher in the control group at 24.1% (95% CI, 18.20 to 30.07) compared with 14.2% (95% CI, 9.38 to 19.05) in the treatment group ( P = 0.0110). At 48 h, the incidence of reintubation was significantly lower in the CPAP group 2.94% (95% CI, 0.60 to 5.28) compared with the control group, 7.39% (95% CI, 3.76 to 11.02), P = 0.0425. No significant differences in pneumonia, sepsis or mortality were observed. CPAP significantly improved oxygenation ( P < 0.0001).
conclusionCPAP did not significantly reduce 28-day reintubation rates compared with oxygen therapy via Venturi mask. However, CPAP was associated with a significant reduction in atelectasis and early reintubation at 48 h. Further research is warranted to confirm these findings and compare CPAP with other noninvasive support strategies.
trial registrationClinicalTrials.gov Identifier: NCT01726140.
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