Systematic review and meta-analysis on perioperative intervention to prevent postoperative atelectasis complications after thoracic surgery.

BACKGROUND

In clinical general thoracic surgery, the prevalence of atelectasis is relatively high. Perioperative interventions can affect the probability of patients with atelectasis after surgery. Therefore, the incidence of perioperative intervention to prevent atelectasis after thoracic surgery was discussed using meta-analysis in this study.

METHODS

The articles were searched in the English database PubMed and Chinese databases including China National Knowledge Infrastructure (CNKI), VIP, and China Journal Full-text Database (CJFD). The duration for publication time of the articles was from the database inception to March 2021, and the articles were required to be randomized controlled trials (RCTs) using interventions [such as changing the dose of general anesthesia, continuous positive end expiratory pressure (PEEP), non-invasive pressure support ventilation, and physical therapy] after thoracic surgery (such as pulmonary lobectomy, sternum surgery, and lung cancer surgery) for the treatment of atelectasis. The software RevMan 5.3 provided by the Cochrane Collaboration was used for meta-analysis.

RESULTS

A total of 5 articles were obtained, including 375 cases in the control group and 268 cases in the intervention treatment group. A meta-analysis was performed on the included articles, combined effect model analysis results showed that compared with the control group, the use of PEEP during mechanical ventilation can significantly reduce the incidence of atelectasis [odds ratio (OR) =0.46; 95% confidence interval (CI): 0.31-0.67; Z=3.94; P<0.0001].

DISCUSSION: Perioperative intervention was more effective for postoperative atelectasis and other complications.