{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T15:42:23Z","timestamp":1776958943396,"version":"3.51.4"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/http:\/\/dx.doi.org\/10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI12\/01223"],"award-info":[{"award-number":["PI12\/01223"]}],"id":[{"id":"10.13039\/http:\/\/dx.doi.org\/10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Insights Imaging"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To evaluate the safety of a minimum continuous positive airway pressure of 4\u2009cmH<jats:sub>2<\/jats:sub>O (CPAP\u2009+\u20094) during computed tomography (CT)-guided radiofrequency ablation (RFA) for lung malignancies under procedural sedation and analgesia (PSA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a prospective, randomised, single-blind, parallel-group, placebo-controlled trial with an open-label medical device conducted at a single tertiary university hospital in Barcelona, Spain. Forty-six patients over 18 years of age scheduled for CT-guided RFA of a malignant pulmonary tumour under PSA were randomised to receive either CPAP\u2009+\u20094 or a modified mask for placebo CPAP (Sham-CPAP). Exclusion criteria included contraindications for RFA, refusal to participate, inability to understand the procedure or tolerate the CPAP test, lung biopsy just prior to RFA, intercurrent diseases, or previous randomisation for additional pulmonary RFA. Primary outcomes were the percentage of patients reporting at least one serious adverse event (SAE), classification for complications from the Cardiovascular and Interventional Radiological Society of Europe (CIRSE), and Clavien-Dindo classifications for complications, hospital stay, and readmissions. Secondary outcomes included adverse events (AEs), respiratory parameters, airway management, and the local radiological efficacy of pulmonary ablation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>CPAP\u2009+\u20094 prolonged hospital stay (1.5\u2009\u00b1\u20091.1 vs. 1.0\u2009\u00b1\u20090 inpatient nights, <jats:italic>p<\/jats:italic>\u2009=\u20090.022) and increased the risk of AE post-RFA (odds ratio (95% CI): 4.250 (1.234 to 14.637), <jats:italic>p<\/jats:italic>\u2009=\u20090.021 with more pneumothorax cases (<jats:italic>n<\/jats:italic>\u2009=\u20095\/22, 22.7% vs. <jats:italic>n<\/jats:italic>\u2009=\u20090\/24, 0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.019). Per-protocol analysis revealed more SAEs and CIRSE grade 3 complications in the CPAP\u2009+\u20094 group (23.5% vs. 0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.036). No significant differences were found in the effectiveness of oxygenation, ventilation, or pulmonary ablation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>CPAP is unsafe during CT-guided RFA for lung cancer under PSA even at the lowest pressure setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ClinicalTrials.Gov, ClinicalTrials.gov ID NCT02117908, Registered 11 April 2014, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/study\/NCT02117908\">https:\/\/www.clinicaltrials.gov\/study\/NCT02117908<\/jats:ext-link><\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Critical relevance statement<\/jats:title>\n                <jats:p>This study highlights the hazards of continuous positive airway pressure during radiofrequency ablation of lung cancer, even at minimal pressures, deeming it unsafe under procedural sedation and analgesia in pulmonary interventional procedures. Findings provide crucial insights to prioritise patient safety.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:list list-type=\"bullet\">\n                  <jats:list-item>\n                    <jats:p>No prior randomised controlled trials on CPAP safety in percutaneous lung thermo-ablation.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>Standardised outcome measures are crucial for radiology research.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>CPAP during lung RFA raises hospital stay and the risk of complications.<\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p>CPAP is unsafe during CT-guided RFA of lung cancer under procedural sedoanalgesia.<\/jats:p>\n                  <\/jats:list-item>\n                <\/jats:list><\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s13244-024-01721-9","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T11:07:28Z","timestamp":1718881648000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Continuous positive airway pressure is unsafe for radiofrequency ablation of lung cancer under sedation: a randomised controlled trial"],"prefix":"10.1186","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3826-5277","authenticated-orcid":false,"given":"Enrique","family":"Carrero-Cardenal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Vollmer-Torrubiano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Torres-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gloria","family":"Mart\u00edn-Barrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgina","family":"Casanovas-Mateu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco-Javier","family":"Tercero-Machin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Paez-Carpio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neus","family":"F\u00e1bregas-Juli\u00e0","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricard","family":"Valero-Castell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"key":"1721_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ccm.2019.10.001","volume":"41","author":"BC Bade","year":"2020","unstructured":"Bade BC, De la Cruz CS (2020) Lung cancer 2020: epidemiology, etiology, and prevention. 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Carn\u00e9 Cladellas) on 16 September 2013. The study was authorised by the Spanish Agency of Medicines and Medical Devices (AEMPS) on 24 March 2014 and registered at ClinicalTrials.gov (NCT02117908) on 11 April 2014. The study was conducted in accordance with the Declaration of Helsinki, and written informed consent was obtained from all patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Competing interests"}},{"value":"The patient provided written consent for the use of medical images (Fig.\u00a0).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"This study aimed to investigate the safety of medical devices for new indications. 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