Updates on Prevention and Management of Perioperative Pulmonary Complications.
Mahmoud Mohammed El Meligy;
Abstract
Postoperative pulmonary complications (PPCs) are one of the most common perioperative adverse events in patients undergoing surgery and contribute to significant increases in morbidity, mortality, and length of postoperative hospital stay.
Although published definitions frequently vary, PPCs generally include respiratory infections, respiratory failure, pleural effusions, atelectasis, pneumothorax, bronchospasm, and aspiration pneumonitis.
The aim of this review is to describe the current evidence underpinning our understanding of PPCs and highlight measures that might become necessary at different points during the course of perioperative care.
The reasons for the occurrence of these complications are multifactorial. The surgery, anaesthesia method that is applied and preoperative risk factors of the patients play an important role, obesity, smoking, age, current chronic lung diseases and other comorbidities are patient risk factors. Apart from these, whereas anaesthesia type, duration, use of different agents and efficacy of postoperative pain treatment are anaesthesia-related risk factors, intervention time, surgical techniques and incision size represent surgical risk factors.
Identifying patients at risk for developing PPCs is essential to preventing them. Predictors for PPCs as whole or specific subsets such as respiratory failure or pneumonia have been identified, including pulmonary, pneumonia, and respiratory failure risk indices.
Understanding the perioperative evaluation of the potential risk for developing pulmonary complication allows the medical team to choose the adequate anesthetic technique and surgical and clinical care required by each patient, thereby reducing adverse respiratory outcomes.
Preoperative screening of pulmonary disease usually depends on the history taking of patients' previous medical history. However, pulmonary disease is seldom diagnosed and treated until patients visit physicians with overt respiratory symptoms.
Although published definitions frequently vary, PPCs generally include respiratory infections, respiratory failure, pleural effusions, atelectasis, pneumothorax, bronchospasm, and aspiration pneumonitis.
The aim of this review is to describe the current evidence underpinning our understanding of PPCs and highlight measures that might become necessary at different points during the course of perioperative care.
The reasons for the occurrence of these complications are multifactorial. The surgery, anaesthesia method that is applied and preoperative risk factors of the patients play an important role, obesity, smoking, age, current chronic lung diseases and other comorbidities are patient risk factors. Apart from these, whereas anaesthesia type, duration, use of different agents and efficacy of postoperative pain treatment are anaesthesia-related risk factors, intervention time, surgical techniques and incision size represent surgical risk factors.
Identifying patients at risk for developing PPCs is essential to preventing them. Predictors for PPCs as whole or specific subsets such as respiratory failure or pneumonia have been identified, including pulmonary, pneumonia, and respiratory failure risk indices.
Understanding the perioperative evaluation of the potential risk for developing pulmonary complication allows the medical team to choose the adequate anesthetic technique and surgical and clinical care required by each patient, thereby reducing adverse respiratory outcomes.
Preoperative screening of pulmonary disease usually depends on the history taking of patients' previous medical history. However, pulmonary disease is seldom diagnosed and treated until patients visit physicians with overt respiratory symptoms.
Other data
| Title | Updates on Prevention and Management of Perioperative Pulmonary Complications. | Other Titles | الحديث في الوقاية والعلاج للمضاعفات الرئوية قبل وأثناء وبعد العمليات الجراحية | Authors | Mahmoud Mohammed El Meligy | Issue Date | 2016 |
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