Variáveis clínicas de risco pré-operatório

Abstract

The variables occurrence that increased chance to POPC in thoracic and upper abdominal surgery were: cough with yellow mucus, thoracic surgery, BMI, duration of smoking and duration of surgery. Regarding the thoracic surgery group the significance variables were wheezing, BMI, duration of smoking and duration of surgery.

Aspectos da função pulmonar após revascularização do miocárdio relacionados com risco pré-operatório

“…Finally, there was no significant difference in the gas exchange index with age, even though the younger group presented with mean values of less than 200 mmHg. The nutritional state is a parameter that has been evaluated in patients submitted to CABG [16], as malnutrition leads to a reduction in the response to hypoxia, diminishing the muscle mass and decreasing the pulmonary defense by proteic-caloric deficiency [3,6].…”

“…While it is possible to wait for improvements of acute respiratory diseases in elective surgeries, this is not possible with chronic diseases. Chronic respiratory diseases increase the numbers of pulmonary complications and when associated to respiratory symptomatology, elevate the risk of PPCs [3]. Smoking increases the risk of PPCs depending on the quantity of cigarettes smoked.…”

“…Cigarettes have noxious effects that are responsible for PPCs and so 8 weeks of abstinence is fundamental to reduce these effects [4,5]. Malnutrition and obesity are also considered risk factors; the first leads to a reduction in the response to hypoxia of the muscle mass and to pulmonary defense due to proteiccaloric deficiency [3,6]; the second makes atelectasis more common and is responsible for a reduction in pulmonary compliance. Thoracic resistance, due to an increase of adipose tissue in this region, may lead to an increase in airway resistance [3,6].…”

“…Malnutrition and obesity are also considered risk factors; the first leads to a reduction in the response to hypoxia of the muscle mass and to pulmonary defense due to proteiccaloric deficiency [3,6]; the second makes atelectasis more common and is responsible for a reduction in pulmonary compliance. Thoracic resistance, due to an increase of adipose tissue in this region, may lead to an increase in airway resistance [3,6]. Comorbidities such as arterial hypertension and diabetes mellitus are related to a higher risk of PPC and it is essential that these diseases are controlled in patients submitted to surgery.…”

Perfil ventilatório dos pacientes submetidos a cirurgia de revascularização do miocárdio

“…Saad and Zambom [22] found decreased lung capacity and FEV 1 in the immediate postoperative period, but full recovery of those values occurred on the fifth postoperative day in major thoraco-abdominal surgery. It does not happen in heart surgery, because, as demonstrated in this study, there is still a significant decrease in lung volume and capacity on the sixth postoperative day.…”