Predicting postoperative pulmonary complications

Sabaté, Sergi; Mazo, Valentín; Canet, Jaume

doi:10.1097/aco.0000000000000045

Cited by 141 publications

(110 citation statements)

References 69 publications

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“…Sabaté et al[24] examined the implications of postoperative pulmonary complications and reported an increased incidence of mortality, length of stay, readmissions, and costs. Our case series gives a limited account of the clinical progression of the patients as well as long term follow up examining the clinical sequelae of their complication.…”

Section: Discussionmentioning

confidence: 99%

Emergent reintubation following elective cervical surgery: A case series

Schroeder

Salzmann

Hughes

et al. 2017

WJO

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AIMTo review cases of emergent reintubation after cervical surgery.METHODSPatients who were emergently intubated in the post-operative period following cervical surgery were identified. The patients’ prospectively documented demographic parameters, medical history and clinical symptoms were ascertained. Pre-operative radiographs were examined for the extent of their pathology. The details of the operative procedure were discerned.RESULTSEight hundred and eighty patients received anterior- or combined anterior-posterior cervical surgery from 2008-2013. Nine patients (1.02%) required emergent reintubation. The interval between extubation to reintubation was 6.2 h [1-12]. Patients were kept intubated after reintubation for 2.3 d [2-3]. Seven patients displayed moderate postoperative edema. One patient was diagnosed with a compressive hematoma which was subsequently evacuated in the OR. Another patient was diagnosed with a pulmonary effusion and treated with diuretics. One patient received a late debridement for an infected hematoma. Six patients reported residual symptoms and three patients made a complete recovery.CONCLUSIONRespiratory compromise is a rare but potentially life threatening complication following cervical surgery. Patients at increased risk should be monitored closely for extended periods of time post-operatively. If the airway is restored adequately in a timely manner through emergent re-intubation, the outcome of the patients is generally favorable.

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Section: Discussionmentioning

confidence: 99%

Emergent reintubation following elective cervical surgery: A case series

Schroeder

Salzmann

Hughes

et al. 2017

WJO

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“…[12] Especially, the postoperative pulmonary complication rates after abdominal surgery were reported to range between 10% and 80%, depending on the definition of the complications. [13] In our study, to appropriately reflect the clinical significance, the definition of postoperative pulmonary complications included clinical manifestations such as productive cough, atelectasis, and pleural effusion, which did not necessarily require interventions such as chest tube insertion. In addition, the characteristics of the study population such as age, body mass index, and comorbidities were dissimilar to the previous study.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for pulmonary complications after percutaneous nephrolithotomy

Choi

Kwon

et al. 2016

Medicine

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Although percutaneous nephrolithotomy is minimally invasive, it is associated with several complications, including extravasation of fluid and urine, the need for a blood transfusion, and septicemia. However, little is known about pulmonary complications after this procedure. Therefore, we aimed to evaluate the risk factors for and outcomes of pulmonary complications after percutaneous nephrolithotomy.All consecutive patients who underwent percutaneous nephrolithotomy between 2001 and 2014 were identified and divided into group A (no clinically significant pulmonary complications) and group B (clinically significant pulmonary complications). Preoperative and intraoperative variables and postoperative outcomes were evaluated. Independent risk factors for postoperative pulmonary complications were evaluated by univariate and multivariate logistic regression analyses.The study included 560 patients: 378 (67.5%) in group A and 182 (32.5%) in group B. Multivariate logistic regression analysis revealed that the independent risk factors for pulmonary complications after percutaneous nephrolithotomy were a higher body mass index (odds ratio = 1.062, P = 0.026), intraoperative red blood cell transfusion (odds ratio = 2.984, P = 0.012), and an intercostal surgical approach (odds ratio = 3.046, P < 0.001). Furthermore, the duration of hospital stay was significantly longer (8.4 ± 4.3 days vs 7.6 ± 3.4 days, P = 0.010) and the intensive care unit admission rate was significantly higher [13 (7.1%) vs 1 (0.3%), P < 0.001] in group B than in group A.Risk factors for pulmonary complications after percutaneous nephrolithotomy were a higher body mass index, intraoperative red blood cell transfusion, and an intercostal surgical approach. Postoperative pulmonary complications were associated with poor outcomes. These results may provide useful information for the perioperative management of pulmonary complications after percutaneous nephrolithotomy.

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“…32,33 These postoperative complications contribute to the risk of surgery, especially cardiothoracic and abdominal-wall surgery. 33 The incidence is higher for patients undergoing thoracic surgery (19 -59%) than for those undergoing upper (16 -20%) or lower (0 -5%) abdominal surgery.…”

Section: Postoperative Adult and Pediatric Patientsmentioning

confidence: 99%

AARC Clinical Practice Guideline: Effectiveness of Pharmacologic Airway Clearance Therapies in Hospitalized Patients

et al. 2015

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Aerosolized medications are used as airway clearance therapy to treat a variety of airway diseases. These guidelines were developed from a systematic review with the purpose of determining whether the use of these medications to promote airway clearance improves oxygenation and respiratory mechanics, reduces ventilator time and ICU stay, and/or resolves atelectasis/consolidation compared with usual care. Recombinant human dornase alfa should not be used in hospitalized adult and pediatric patients without cystic fibrosis. The routine use of bronchodilators to aid in secretion clearance is not recommended. The routine use of aerosolized N-acetylcysteine to improve airway clearance is not recommended. Aerosolized agents to change mucus biophysical properties or promote airway clearance are not recommended for adult or pediatric patients with neuromuscular disease, respiratory muscle weakness, or impaired cough. Mucolytics are not recommended to treat atelectasis in postoperative adult or pediatric patients, and the routine administration of bronchodilators to postoperative patients is not recommended. There is no high-level evidence related to the use of bronchodilators, mucolytics, mucokinetics, and novel therapy to promote airway clearance in these populations.

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Predicting postoperative pulmonary complications

Cited by 141 publications

References 69 publications

Emergent reintubation following elective cervical surgery: A case series

Emergent reintubation following elective cervical surgery: A case series

Risk factors for pulmonary complications after percutaneous nephrolithotomy

AARC Clinical Practice Guideline: Effectiveness of Pharmacologic Airway Clearance Therapies in Hospitalized Patients

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