ICOUGH: A multidisciplinary strategy to reduce postoperative pulmonary complications

Cassidy, Michael R.; Rosenkranz, Pamela; Weinstock, Karen; McAneny, David

doi:10.1016/j.jamcollsurg.2012.06.282

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ICOUGH program was developed by Boston University Medical Center in 2012 that was an abbreviation for; incentive spirometry, coughing/deep breathing, oral care, getting out of bed, and head bed elevation. They were able to reduce post-operative pneumonia from 2.13 (observed/expected ratio) to 1.58 (odds ratio) [ 1 ]. A modified European protocol was later developed by Manchester University Hospital in the year of 2017 that added to ICOUGH program a pre-operative management plan that included smoking cessation, reduction of alcohol intake, and dietary, and life-style recommendations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of a perioperative pulmonary care bundle implementation on postoperative outcomes in 1,665 surgical cancer patients: experience from a tertiary referral cancer center in Jordan

et al. 2021

View full text Add to dashboard Cite

Background Postoperative pulmonary complications can be a major catastrophic consequence of major surgeries and can lead to increased morbidity, mortality, hospital stay, and cost. Many protocols have been tried to reduce serious adverse outcomes with effective strategies including a bundle of preoperative, intraoperative and postoperative techniques. Using these techniques maybe challenging in developing countries with limited resources even in specialized centers. Methods A before-and-after trial comparing our data from the national surgical quality improvement program (NSQIP) based on their reports. Data was collected prospectively for the patients who underwent major surgeries at King Hussein Cancer Center during the year 2017 when the use of the perioperative pulmonary care bundle was mandatory to all surgery teams and compared it with the data collected retrospectively for the patients who underwent the same type of surgeries in the year 2016 when the use of such a bundle was optional. The primary end point is the decrease in incidence of postoperative pulmonary complications. Simple descriptive statistical analysis was used to obtain results. Results The potential risk factors for postoperative pulmonary complications for 1665 patients divided into 2 groups (2016 vs. 2017); 764 (45.9%) vs. 901 (54.1%), respectively. There were no significant differences regarding gender (male 46.7% vs. 46.4%, P value = 0.891, female 53.3% vs. 53.6%, P value = 0.39), mean of age (53.5 year vs. 5.28 year, P value = 0.296), mean of body mass index (BMI) (28.6 vs. 6%, 28.6, P value = 0.95), smoking status; (69.6% vs. 65.1%, P value = 0.052), ventilator use (0.3% vs. 0.4% P value = 0.693) and chronic obstructive pulmonary disease (1.4% vs. 1.4 with, P value = 0.996).The data showed a significant reduction in postoperative pneumonia between the 2 groups (2016 vs. 2017) (2.7% vs. 0.9%, P value = 0.004) and showed a significant reduction in unplanned intubation, 1.4% in 2016 vs. 0.7% in 2017. Conclusions The standardization of perioperative pulmonary care bundle, including smoking cessation, perioperative pulmonary interventions and early mobilization, significantly reduces the incidence of postoperative pulmonary complications in cancer patients. This technique's implementation was feasible easily even with limited resources in a developing country like Jordan.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Postoperative pulmonary complications are a leading cause of postoperative morbidity and mortality, increasing critical care and hospital length of stay [ 1 ]. Patients undergoing major surgery and who are exposed to general anesthesia have a higher risk for development of postoperative pulmonary complications [ 2 ].…”

Section: Introductionmentioning

confidence: 99%