AIM: Patients undergoing thoracotomy or heart surgery are at risk of developing postoperative pulmonary complications (PPC) such as pneumonia, arterial hypoxemia, need of re-intubation, atelectasis and acute respiratory failure (ARF). Non-invasive ventilation (NIV) may be an important tool to prevent or to treat ARF by reducing the work of breathing and improving alveolar recruitment in order to promote a better recovery of patients and reducing the length of stay (LOS) in the hospital or in intensive care unit. The objective of this review was to assess the efficacy of NIV in treatment of patients recovering from cardiothoracic surgery. METHODS: Electronic databases were searched for randomised controlled trials (RCTs) comparing NIV with other respiratory techniques in adult who underwent heart or thoracic surgery. The primary and secondary outcomes were LOS and incidence of PPC respectively. RESULTS: Thirteen RCTs are included in this review, most of which are of low quality. Twelve RCTs used prophylactic NIV and one a curative NIV. CONCLUSION: Prophylactic NIV seems to be effective in reducing LOS in patients at high risk of developing PPC and it can decrease the incidence of PPC in low risk patients. Curative NIV seems to be effective in reducing the rate of intubation and the mortality in patients presenting ARF. Further studies are necessary to better define a protocol to improve efficacy and preserving safety.

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