An Evaluation of Preoperative Methods of Preventing Postoperative Pulmonary Complications

Abstract

The effectivelless of three current regimes of prcoperative respiratory care in reducing postoperatiL'e respiratory complicatiolls follo1£'illg herniorrhaphy was studied prospectively. Xo smoking for fi,'e days plus intensive physiotherapy, five days no smoking, and routine hospital admission two days preoperatively were the regimes. Clinical, bacteriological, chest X-ray, blood gas and respiratory function test data were the criteria for assessment. The same surgical and anaesthetic team performed each operation. No statistical difference between the groups for pulmonary complications was noted. A significant correlation was found between the preoperative vital capacity and arterial P02; also between the preoperative forced expiratory volume in one second-vital capacity ratio with the postoperative arterial P02'

Identifying and recruiting smokers for preoperative smoking cessation—a systematic review of methods reported in published studies

“…Help from waiting list staff was acknowledged. At the time of waiting list placement (>4 weeks) ≥4 weeks Wheatley et al 1977 [ 41 ] (Australia) Inguinal hernia repair 15 (NA) Patients (15 smokers and 15 non-smokers) were assigned arbitrarily to one of three groups. Recruiting methods not reported.…”

“…No studies that compared different methods for identifying and recruiting smokers for preoperative smoking cessation were identified. There were 18 randomised controlled trials (RCTs) [ 10 – 27 ] and 14 non-randomised studies (NRS) [ 28 – 41 ]. The included studies were conducted in the USA ( n = 10), Australia ( n = 5), UK ( n = 6), Denmark ( n = 6), Canada ( n = 4), and Sweden ( n = 1).…”

Prognostic value of the early lung ultrasound B-line score for postoperative pulmonary insufficiency in patients undergoing thoracic surgery: an observational study

“…However, postoperative pulmonary insufficiency (PPI) is still the major cause of morbidity and significantly affects several aspects of morbidity, including the length of hospital stay and unexpected intensive care unit admissions [ 3 – 5 ]. Several risk stratification models for PPI have described patient-specific risk factors, including age, sex, preoperative hypoalbuminemia, anemia and surgical or anesthesiological factors, including the extent of resected lung tissue, surgical time, surgical approach via thoracotomy versus video-assisted thoracoscopy, excessive fluid administration, inappropriate ventilation strategies, and inadequate postoperative analgesia [ 6 – 10 ]. The interaction of the above risk factors can lead to a large amount of fluid entering the third space and even obvious pulmonary interstitial edema in severe patients, which ultimately provides a pathophysiological basis for the occurrence of PPI.…”

PHYSIO+++: protocol for a pilot randomised controlled trial assessing the feasibility of physiotherapist-led non-invasive ventilation for patients with hypoxaemia following abdominal surgery

“…Hypoxaemia in the early postoperative period following major abdominal surgery is common in the first 3 postoperative days,1 occurring in up to 65% of patients 1–4. Persistent hypoxaemia can lead to serious postoperative pulmonary complications (PPC) including respiratory failure, admission to intensive care for mechanical ventilation, high hospital resource utilisation, prolonged length of stay and increased risk of mortality 1 2 4–8…”