Assessment of Pre-operative Noninvasive Ventilation before Lung cancer Surgery: the preOVNI Randomized Controlled Study

Abstract Objectives The preOVNI study was a randomized controlled open-label study that investigated whether pre-operative noninvasive ventilation (NIV) could reduce post-operative complications after lung cancer surgery. Methods Adult patients with planned lung cancer resection and with at least one cardiac or respiratory comorbidity were included and randomly assigned to preoperative NIV (at least 7 days and 4 h/day) or no NIV. The primary endpoint was the rate of post-operative protocol-defined complications. Results Three hundred patients were included. In the NIV group, the median NIV duration was 8 days. No difference of post-operative complication rates was evidenced: 42.6% in NIV group and 44.8% in no-NIV group (p=0.75). The rate of pneumonia was higher in no-NIV group compared to NIV group, but statistical significance was not achieved (28.0 vs. 37.7%, respectively; p=0.08). The type of surgery (open or mini-invasive) did not impact these results after multivariable analysis. Conclusion No benefit was evidenced for preoperative NIV before lung cancer surgery. Further studies should determine the optimal peri-operative management to decrease the rate of post-operative complications.