The primary outcome measure is a composite endpoint of pneumonia, re-intubation or death within 30 days of randomisation. We have recruited 4800 patients over the age of 50 and undergoing major elective intra-peritoneal surgery and are now completing data collection. PRISM is a large international, multi-centre, pragmatic, randomised controlled trial with open study group allocation to determine whether early postoperative continuous positive airway pressure (CPAP) reduces the incidence of subsequent respiratory complications and improves one year survival following major intra-peritoneal surgery. However, it is not a part of routine practice because evidence of clinical effectiveness is lacking. Evidence from small trials (n<200) suggests that routine postoperative continuous positive airway pressure (CPAP) reduces pulmonary complications after abdominal surgery. This is particularly important for major abdominal procedures because of the impact of this type of surgery on respiratory function. The most common of these affect the respiratory tract. Surgical complications are associated with reduced long-term survival.

1-4% of the two million surgical procedures carried out in the UK every year result in death. Mortality and morbidity after surgery are major healthcare problems. Prevention of Respiratory Insufficiency after Surgical Management (PRISM) Trial: International, multi-centre, pragmatic trial of CPAP after major abdominal surgeryįollow Trial Report in The Lancet Respiratory Medicine / DOI: S2213-2600(21)00089-8

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