Postoperative study of vital capacity and ventilation measurements following elective craniotomy

Sogame, Luciana Carrupt Machado; Faresin, Sônia Maria; Vidotto, Milena Carlos; Jardim, José Roberto

doi:10.1590/s1516-31802008000100003

Cited by 7 publications

(8 citation statements)

References 36 publications

(42 reference statements)

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“…Some studies have found an association between smoking status and the incidence of pulmonary complications, 20 while others have not found this correlation. 22,23 Reductions in VC and respiratory muscle strength occurred in all groups in our study, with a greater negative impact (diminished VC) on the thoracic group than on the lumbar group.…”

Section: 20supporting

confidence: 46%

Evaluation of lung volumes, vital capacity and respiratory muscle strength after cervical, thoracic and lumbar spinal surgery

et al. 2015

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Evaluation of lung volumes, vital capacity and respiratory muscle strength after cervical, thoracic and lumbar spinal surgeryAvaliação dos volumes pulmonares, capacidade vital e força dos músculos respiratórios no pós-operatório de cirurgia na coluna cervical, torácica e lombar Marcio Aparecido Oliveira I , Milena Carlos Vidotto II , Oliver Augusto Nascimento III , Renato Almeida IV , Ilka Lopes Santoro V , Evandro Fornias Sperandio VI , José Roberto Jardim VII , Mariana Rodrigues Gazzotti VIII Universidade Federal de São Paulo ABSTRACTCONTEXT AND OBJECTIVE: Studies have shown that physiopathological changes to the respiratory system can occur following thoracic and abdominal surgery. Laminectomy is considered to be a peripheral surgical procedure, but it is possible that thoracic spinal surgery exerts a greater influence on lung function. The aim of this study was to evaluate the pulmonary volumes and maximum respiratory pressures of patients undergoing cervical, thoracic or lumbar spinal surgery. DESIGN AND SETTING: Prospective study in a tertiary-level university hospital. METHODS: Sixty-three patients undergoing laminectomy due to diagnoses of tumors or herniated discs were evaluated. Vital capacity, tidal volume, minute ventilation and maximum respiratory pressures were evaluated preoperatively and on the first and second postoperative days. Possible associations between the respiratory variables and the duration of the operation, surgical diagnosis and smoking status were investigated. RESULTS: Vital capacity and maximum inspiratory pressure presented reductions on the first postoperative day (20.9% and 91.6%, respectively) for thoracic surgery (P = 0.01), and maximum expiratory pressure showed reductions on the first postoperative day in cervical surgery patients (15.3%; P = 0.004). The incidence of pulmonary complications was 3.6%. CONCLUSIONS: There were reductions in vital capacity and maximum respiratory pressures during the postoperative period in patients undergoing laminectomy. Surgery in the thoracic region was associated with greater reductions in vital capacity and maximum inspiratory pressure, compared with cervical and lumbar surgery. Thus, surgical manipulation of the thoracic region appears to have more influence on pulmonary function and respiratory muscle action.RESUMO CONTEXTO E OBJETIVO: Estudos têm demonstrado que alterações fisiopatológicas no sistema respirató-rio podem ocorrer após cirurgia torácica e abdominal. A laminectomia é considerada uma cirurgia perifé-rica, mas é possível que as cirurgias de coluna torácica exerçam maior influência sobre a função pulmonar. O objetivo do estudo foi avaliar os volumes pulmonares e as pressões respiratórias máximas em pacientes submetidos a cirurgia de coluna cervical, torácica ou lombar. TIPO DE ESTUDO E LOCAL: Estudo prospectivo em hospital universitário terciário. MÉTODOS: Sessenta e três pacientes submetidos a laminectomia com diagnóstico tumor ou hérnia de disco foram avaliados. Foram avaliados, no pré-operatório, no primeiro e no segundo ...

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Section: 20supporting

confidence: 46%

Evaluation of lung volumes, vital capacity and respiratory muscle strength after cervical, thoracic and lumbar spinal surgery

et al. 2015

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“…Mechanical ventilation for more than 48 hours may contribute towards pulmonary complications in patients who have undergone intracranial surgery, 24 and to worsening of gas exchanges. 25 These complications may also contribute towards reintubation.…”

Section: Resultsmentioning

confidence: 99%

Incidence, indication and complications of postoperative reintubation after elective intracranial surgery

Hayashi¹,

Gazzotti

Vidotto

et al. 2013

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: There are no reports on reintubation incidence and its causes and consequences during the postoperative period following elective intracranial surgery. The objective here was to evaluate the incidence of reintubation and its causes and complications in this situation. DESIGN AND SETTING: Prospective cohort study, using data obtained at a tertiary university hospital between 2003 and 2006. METHODS: 169 patients who underwent elective intracranial surgery were studied. Preoperative assessment was performed and the patients were followed up until hospital discharge or death. The rate of reintubation with its causes and complications was ascertained. RESULTS:The incidence of reintubation was 12.4%, and the principal cause was lowered level of consciousness (71.5%). There was greater incidence of reintubation among females (P = 0.028), and greater occurrence of altered level of consciousness at the time of extubation (P < 0.0001). Reintubated patients presented longer duration of mechanical ventilation (P < 0.0001), longer stays in the intensive care unit (ICU) and in the hospital (P < 0.0001), greater incidence of pulmonary complications (P < 0.0001), greater need for reoperation and tracheostomy, and higher mortality (P < 0.0001). CONCLUSION:The incidence of reintubation in these patients was 12.4%. The main cause was lowering of the level of consciousness. Female gender and altered level of consciousness at the time of extubation correlated with higher incidence of reintubation. Reintubation was associated with pulmonary complications, longer durations of mechanical ventilation, hospitalization and stay in the ICU, greater incidence of tracheostomy and mortality.RESUMO CONTEXTO E OBJETIVO: Não há relatos sobre incidência de reintubação, suas causas e consequências no pós-operatório de cirurgia intracraniana eletiva. O objetivo foi avaliar a incidência de reintubação, suas causas e complicações em pós-operatório de cirurgia intracraniana eletiva. TIPO DE ESTUDO E LOCAL: Estudo de coorte prospectivo, com dados que foram obtidos de 2003 a 2006 em um hospital universitário terciário. MÉTODO: 169 pacientes submetidos a cirurgia intracraniana eletiva foram estudados. Foi realizada avaliação pré-operatória e os pacientes foram acompanhados até a alta hospitalar ou óbito, verificando a taxa de reintubação, suas causas e complicações. RESULTADOS: A incidência de reintubação foi de 12,4% sendo a principal causa o rebaixamento do nível de consciência (71,5%). Houve maior incidência de reintubação no sexo feminino (P = 0,028), bem como do nível de consciência alterado no momento da extubação (P < 0,0001). Pacientes reintubados apresentaram maior tempo de ventilação mecânica (P < 0,0001) e de internação em unidade de terapia intensiva (UTI) e hospitalar (P < 0,0001), maior incidência de complicações pulmonares (P < 0,0001), maior necessidade de reoperação e traqueostomia, além de aumento de mortalidade (P < 0,0001). CONCLUSÃO: A incidência de reintubação nesses pacientes foi de 12,4%. A principal...

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“…Prolonged MV is considered to be a risk factor for the development of pneumonia (21,(27)(28)(29). A number of cardiac surgery studies have reported a higher incidence of respiratory complications in patients subjected to prolonged MV.…”

Section: Discussionmentioning

confidence: 99%

Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Vidotto

Sogame

Gazzotti

et al. 2011

Braz J Med Biol Res

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48 h) until discharge from the hospital or death. The occurrence of PPC, incidence of death, the need for reoperation and tracheostomy, and the length of hospitalization were assessed during the postoperative period. Twenty-six patients (8.2%) experienced extubation failure and 30 (9.5%) needed prolonged MV after surgery. Multivariate analysis showed that extubation failure was significant for the occurrence of death (OR = 8.05 [1.88; 34.36]), PPC (OR = 11.18 [2.27; 55.02]) and tracheostomy (OR = 7.8 [1.12; 55.07]). Prolonged MV was significant only for the occurrence of PPC (OR = 4.87 [1.3; 18.18]). Elective intracranial surgery patients who experienced extubation failure or required prolonged MV had a higher incidence of PPC, reoperation and tracheostomy and required a longer period of time in the ICU. Level of consciousness and extubation failure were associated with death and PPC. Patients who required prolonged MV had a higher incidence of extubation failure.]]>

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Postoperative study of vital capacity and ventilation measurements following elective craniotomy

Cited by 7 publications

References 36 publications

Evaluation of lung volumes, vital capacity and respiratory muscle strength after cervical, thoracic and lumbar spinal surgery

Evaluation of lung volumes, vital capacity and respiratory muscle strength after cervical, thoracic and lumbar spinal surgery

Incidence, indication and complications of postoperative reintubation after elective intracranial surgery

Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

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