Preoperative Cessation of Smoking and Pulmonary Complications in Coronary Artery Bypass Patients

Warner, Mark A.; Divertie, Matthew B.; Tinker, John H.

doi:10.1097/00000542-198404000-00022

Cited by 208 publications

(72 citation statements)

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“…Zwar et al [19] conducted a short-term evaluation of bupropion in 151 patients attending general practitioners, and found that, although effective in improving smoking cessation rates, 83 (68%) reported side effects and fewer than 20% of all patients completed a full course of treatment. Studies of the adverse effects of smoking in surgical patients have mainly focused on cardiopulmonary risk reduction, but recent studies identify an association with wound infection [4][5][6][7][8][9][10]. In an exploratory analysis of a randomised trial of maintenance of peri-operative normothermia, smokers had a 10-fold increased risk of wound infection after colorectal surgery when compared with non-smokers [10].…”

Section: Discussionmentioning

confidence: 99%

“…All patients were informed of the accepted health risks of smoking and particularly the risk of smoking in relation to surgery and anaesthesia [2][3][4][5][6][7][8][9][10][11]. They were then advised to give up smoking and given a 'Smoking and Anaesthesia' booklet published by the Victorian Department of Health and Human Services.…”

Section: Methodsmentioning

confidence: 99%

“…Over 20% of those now living in developed countries will eventually be killed by tobacco [1]. Smoking also increases the risk of complications in patients undergoing surgery [2][3][4][5][6][7][8][9][10][11]. For this reason, it is recommended that smokers should be advised to stop smoking for at least 6 weeks before elective surgery [2,3].…”

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confidence: 99%

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Effectiveness of bupropion as an aid to stopping smoking before elective surgery: a randomised controlled trial

et al. 2004

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SummarySmoking is a risk factor for complications during and after surgery, but most smokers are unable to quit before elective surgery. We tested the efficacy of bupropion in improving smoking cessation rates in this setting by enrolling 47 patients from the elective surgery waiting list in a double-blind randomised controlled trial. Patients receiving bupropion had a lower daily cigarette consumption at the time of hospital admission, median (IQR) cigarettes per day: 6 (2-7) vs. 15 (9-20), p = 0.046. They also had a reduction in end-expired carbon monoxide (p = 0.004), a known contaminant of cigarette smoke, and increased arterial oxygen saturation on pulse oximetry (p = 0.011). They were more likely to have stopped smoking at the 3-week visit (p = 0.036), but not at the 6-week visit (p = 0.25) or at the time of hospital admission for surgery (p > 0.99). This study found that smokers waiting for elective surgery are more likely to reduce or stop smoking when treated with bupropion.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Effectiveness of bupropion as an aid to stopping smoking before elective surgery: a randomised controlled trial

et al. 2004

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“…Current smoker has an additional risk, and there is a correlation between the cumulative amount of smoking and the risk of PPCs [33]. A randomized, controlled trial has demonstrated that patients ceased smoking for 6–8 weeks before elective major orthopedic surgery had a reduced risk of PPCs [34].…”

Section: Risk Factors For Ppcsmentioning

confidence: 99%

Pre-operative pulmonary assessment for patients with hip fracture

Siu

Tse

et al. 2010

Osteoporos Int

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Hip fracture is a common injury among the elderly. Although patients who receive hip fracture surgery carry the best functional recovery compared to other treatment modalities, the presence of postoperative pulmonary complications, such as atelectasis, pneumonia, and pulmonary thromboembolism, may contribute to increased length of hospital stay, perioperative morbidity, and mortality. This review aims to provide evidence-based recommendations for preoperative assessment and perioperative strategies to reduce the risk of pulmonary complications after hip fracture surgery. Clinical assessment and basic laboratory results are sufficient to stratify the risk of postoperative pulmonary complications. Well-documented risk factors for pulmonary complications include advanced age, poor general health status, current infections, pre-existing cardiopulmonary diseases, hypoalbuminemia, and impaired renal function. Apart from optimizing the patient's medical conditions, interventions such as lung expansion maneuvers and thromboprophylaxis have been proven to be effective in reducing the risk of pulmonary complications after hip fracture surgery.

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“…reduction in lung capacity, increased shunt, production of mucus and impairment of the normal mechanics of mucus clearance, such as ciliary activity, leading to productive coughing [4,14]. There is a connection between frequent smoking and increased risk of PPC [12], and a level of >20 pack-years (1 pack-year = 1 package a day for 1 year) has been suggested to imply a higher risk of PPC [15]. …”

Section: Smokingmentioning

confidence: 99%

Chest physical therapy in surgery: a theoretical model about who to treat

Olsén¹

2005

Breathe

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Preoperative Cessation of Smoking and Pulmonary Complications in Coronary Artery Bypass Patients

Cited by 208 publications

References 0 publications

Effectiveness of bupropion as an aid to stopping smoking before elective surgery: a randomised controlled trial

Effectiveness of bupropion as an aid to stopping smoking before elective surgery: a randomised controlled trial

Pre-operative pulmonary assessment for patients with hip fracture

Chest physical therapy in surgery: a theoretical model about who to treat

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