Surgery pp 1481-1490 | Cite as

Preoperative and Postoperative Care of the Thoracic Surgery Patient

  • Jessica Scott Donington


Major pulmonary and esophageal procedures place tremendous physiological stress on patients. Over the past three decades, the morbidity and mortality associated with thoracic surgical procedures has dropped significantly. This increase in safety is attributable to a shift in disease process from infectious to malignant, and advances in anesthetic techniques, surgical precision, patient selection, and perioperative care. The process of patient selection includes better preoperative staging of malignancy and physiological assessment and evaluation of fitness for operation. Today, a grand majority of general thoracic operations are performed for malignancy; we treat far fewer infectious processes than our predecessors. Our patients in general are better fit for surgery and their expectation for full functional recovery is much higher. We review some significant points in perioperative care of thoracic surgery patients including preoperative cardiac and pulmonary assessment, perioperative antibiotic use, pain management, chest tube management, and the use of postoperative anticoagulants and antiarrhythmics.


Deep Venous Thrombosis Chest Tube Lung Resection Pulmonary Resection Noncardiac Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hole DJ, Watt GC, Davey-Smith G, Hart CL, Gillis CR, Hawthorne VM. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ 1996;313(7059):711–715.PubMedGoogle Scholar
  2. 2.
    Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002;347(20):1557–1565.PubMedCrossRefGoogle Scholar
  3. 3.
    Au DH, Lemaitre RN, Curtis JR, Smith NL, Psaty BM. The risk of myocardial infarction associated with inhaled beta-adrenocep-tor agonists. Am J Respir Crit Care Med 2000;161(3 pt 1):827–830.PubMedGoogle Scholar
  4. 4.
    Volterrani M, Scalvini S, Mazzuero G, et al. Decreased heart rate variability in patients with chronic obstructive pulmonary disease. Chest 1994;106(5):1432–1437.PubMedCrossRefGoogle Scholar
  5. 5.
    The Society of Thoracic Surgeons. General Thoracic Surgery Procedure Database. Chicago: The Society of Thoracic Surgeons, 2005.Google Scholar
  6. 6.
    Goldman L, Caldera DL, Nussbaum SR, et al. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 1977;297(16):845–850.PubMedGoogle Scholar
  7. 7.
    Eagle KA, Brundage BH, Chaitman BR, et al. Guidelines for perioperative cardiovascular evaluation for noncardiac surgery. Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). J Am Coll Cardiol 1996;27(4):910–948.PubMedCrossRefGoogle Scholar
  8. 8.
    Eagle KA, Berger PB, Calkins H, et al. ACC/AHA guideline update for perioperative cardiovascular evaluation for noncardiac surgery. Executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1996 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Circulation 2002;105(10):1257–1267.PubMedGoogle Scholar
  9. 9.
    Ashley EA, Raxwal VK, Froelicher VF. The prevalence and prognostic significance of electrocardiographic abnormalities. Curr Probl Cardiol 2000;25(1):1–72.PubMedCrossRefGoogle Scholar
  10. 10.
    Kertai MD, Boersma E, Bax JJ, et al. A meta-analysis comparing the prognostic accuracy of six diagnostic tests for predicting perioperative cardiac risk in patients undergoing major vascular surgery. Heart 2003;89:1327–1334.PubMedCrossRefGoogle Scholar
  11. 11.
    Mangano DT, Layug EL, Wallace A, Tateo I. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med 1996;335(23):1713–1720.PubMedCrossRefGoogle Scholar
  12. 12.
    Poldermans D, Boersma E, Bax JJ, et al. The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echo-cardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. N Engl J Med 1999;341(24):1789–1794.PubMedCrossRefGoogle Scholar
  13. 13.
    Andrus MR, Holloway KP, Clark DB. Use of beta-blockers in patients with COPD. Ann Pharmacother 2004;38(1):142–145.PubMedCrossRefGoogle Scholar
  14. 14.
    Salpeter SR, Ormiston TM, Salpeter EE, Poole PJ, Cates CJ. Cardioselective beta-blockers for chronic obstructive pulmonary disease: a meta-analysis. Respir Med 2003;97(10):1094–1101.PubMedCrossRefGoogle Scholar
  15. 15.
    Gottlieb SS, McCarter RJ, Vogel RA. Effect of beta-blockade on mortality among high-risk and low-risk patients after myocardial infarction. N Engl J Med 1998;339(8):489–497.PubMedCrossRefGoogle Scholar
  16. 16.
    Myrdal G, Gustafsson G, Lambe M, Horte LG, Stahle E. Outcome after lung cancer surgery. Factors predicting early mortality and major morbidity. Eur J Cardiothorac Surg 2001;20(4):694–699.PubMedCrossRefGoogle Scholar
  17. 17.
    Moores LK. Smoking and postoperative pulmonary complications. An evidence-based review of the recent literature. Clin Chest Med 2000;21(1):139–146.PubMedCrossRefGoogle Scholar
  18. 18.
    Matsuoka H, Nishio W, Sakamoto T, Harada H, Tsubota N. Prediction of morbidity after lung resection with risk factors using treadmill exercise test. Eur J Cardiothorac Surg 2004;26(3):480–482.PubMedCrossRefGoogle Scholar
  19. 19.
    Gerson MC, Hurst JM, Hertzberg VS, Baughman R, Rouan GW, Ellis K. Prediction of cardiac and pulmonary complications related to elective abdominal and noncardiac thoracic surgery in geriatric patients. Am J Med 1990;88(2):101–107.PubMedCrossRefGoogle Scholar
  20. 20.
    Epstein SK, Faling LJ, Daly BD, Celli BR. Predicting complications after pulmonary resection. Preoperative exercise testing vs. a multifactorial cardiopulmonary risk index. Chest 1993;104(3):694–700.PubMedCrossRefGoogle Scholar
  21. 21.
    Epstein SK, Faling LJ, Daly BD, Celli BR. Inability to perform bicycle ergometry predicts increased morbidity and mortality after lung resection. Chest 1995;107(2):311–316.PubMedCrossRefGoogle Scholar
  22. 22.
    Reilly DF, McNeely MJ, Doerner D, et al. Self-reported exercise tolerance and the risk of serious perioperative complications. Arch Intern Med 1999;159(18):2185–2192.PubMedCrossRefGoogle Scholar
  23. 23.
    Boushy SF, Billig DM, North LB, Helgason AH. Clinical course related to preoperative and postoperative pulmonary function in patients with bronchogenic carcinoma. Chest 1971;59(4):383–391.PubMedCrossRefGoogle Scholar
  24. 24.
    Miller JI Jr. Physiologic evaluation of pulmonary function in the candidate for lung resection. J Thorac Cardiovasc Surg 1993;105(2):347–351.PubMedGoogle Scholar
  25. 25.
    Wernly JA, DeMeester TR, Kirchner PT, Myerowitz PD, Oxford DE, Golomb HM. Clinical value of quantitative ventila-tion-perfusion lung scans in the surgical management of bronchogenic carcinoma. J Thorac Cardiovasc Surg 1980;80(4):535–543.PubMedGoogle Scholar
  26. 26.
    Wyser C, Stultz P, Soler M, et al. Prospective evaluation of an algorithm for the functional assessment of lung resection candidates. Am J Resp Crit Care Med 1999:159(5.1):1450–1456.PubMedGoogle Scholar
  27. 27.
    Ferguson MK, Little L, Rizzo L, et al. Diffusing capacity predicts morbidity and mortality after pulmonary resection. J Thorac Cardiovasc Surg 1988;96(6):894–900.PubMedGoogle Scholar
  28. 28.
    Ferguson MK, Reeder LB, Mick R. Optimizing selection of patients for major lung resection. J Thorac Cardiovasc Surg 1995;109(2):275–281.PubMedCrossRefGoogle Scholar
  29. 29.
    Wang J, Olak J, Ultmann RE, Ferguson MK. Assessment of pulmonary complications after lung resection. Ann Thorac Surg 1999;67(5):1444–1447.PubMedCrossRefGoogle Scholar
  30. 30.
    Olsen GN, Block AJ, Swenson EW, Castle JR, Wynne JW. Pulmonary function evaluation of the lung resection candidate: a prospective study. Am Rev Respir Dis 1975;111(4):379–387.PubMedGoogle Scholar
  31. 31.
    Kearney DJ, Lee TH, Reilly JJ, DeCamp MM, Sugarbaker DJ. Assessment of operative risk in patients undergoing lung resection. Importance of predicted pulmonary function. Chest 1994;105(3):753–759.PubMedCrossRefGoogle Scholar
  32. 32.
    Putnam JB Jr, Lammermeier DE, Colon R, McMurtrey MJ, Ali MK, Roth JA. Predicted pulmonary function and survival after pneumonectomy for primary lung carcinoma. Ann Thorac Surg 1990;49(6):909–914.PubMedCrossRefGoogle Scholar
  33. 33.
    Cooper JD, Patterson GA, Sundaresan RS, et al. Results of 150 consecutive bilateral lung volume reduction procedures in patients with severe emphysema. J Thorac Cardiovasc Surg 1996;112(5):1319–1329.PubMedCrossRefGoogle Scholar
  34. 34.
    Wahi R, McMurtrey MJ, DeCaro LF, et al. Determinants of perioperative morbidity and mortality after pneumonectomy. Ann Thorac Surg 1989;48(1):33–37.PubMedGoogle Scholar
  35. 35.
    Juhl B, Frost N. A comparison between measured and calculated changes in the lung function after operation for pulmonary cancer. Acta Anaesthesiol Scand Suppl 1975;57:39–45.PubMedCrossRefGoogle Scholar
  36. 36.
    Olsen GN, Bolton JW, Weiman DS, Hornung CA. Stair climbing as an exercise test to predict the postoperative complications of lung resection. Two years’ experience. Chest 1991;993):587–590.CrossRefGoogle Scholar
  37. 37.
    Pate P, Tenholder MF, Griffin JP, Eastridge CE, Weiman DS. Preoperative assessment of the high-risk patient for lung resection. Ann Thorac Surg 1996;61(5):1494–1500.PubMedCrossRefGoogle Scholar
  38. 38.
    Van Nostrand D, Kjelsberg MO, Humphrey EW. Preresectional evaluation of risk from pneumonectomy. Surg Gynecol Obstet 1968;127(2):306–312.PubMedGoogle Scholar
  39. 39.
    Girish M, Trayner E Jr, Dammann O, Pinto-Plata V, Celli B. Symptom-limited stair climbing as a predictor of postoperative cardiopulmonary complications after high-risk surgery. Chest 2001;120(4):1147–1151.PubMedCrossRefGoogle Scholar
  40. 40.
    Brunelli A, Al Refai M, Monteverde M, Borri A, Salati M, Fianchini A. Stair climbing test predicts cardiopulmonary complications after lung resection. Chest 2002;121(4):1106–1110.PubMedCrossRefGoogle Scholar
  41. 41.
    Holden DA, Rice TW, Stelmach K, Meeker DP. Exercise testing, 6-min walk, and stair climb in the evaluation of patients at high risk for pulmonary resection. Chest 1992;102(6):1774–1779.PubMedCrossRefGoogle Scholar
  42. 42.
    Singh SJ, Morgan MD, Hardman AE, Rowe C, Bardsley PA. Comparison of oxygen uptake during a conventional treadmill test and the shuttle walking test in chronic airflow limitation. Eur Respir J 1994;7(11):2016–2020.PubMedGoogle Scholar
  43. 43.
    Abbott RD, Levy D, Kannel WB, et al. Cardiovascular risk factors and graded treadmill exercise endurance in healthy adults: The Framingham Offspring Study. Am J Cardiol 1989;63(5):342–346.PubMedCrossRefGoogle Scholar
  44. 44.
    Morice RC, Peters EJ, Ryan MB, Putnam JB, Ali MK, Roth JA. Exercise testing in the evaluation of patients at high risk for complications from lung resection. Chest 1992;101(2):356–361.PubMedCrossRefGoogle Scholar
  45. 45.
    Olsen GN, Weiman DS, Bolton JW, et al. Submaximal invasive exercise testing and quantitative lung scanning in the evaluation for tolerance of lung resection. Chest 1989;95(2):267–273.PubMedCrossRefGoogle Scholar
  46. 46.
    Bolliger CT, Wyser C, Roser H, Soler M, Perruchoud AP. Lung scanning and exercise testing for the prediction of postoperative performance in lung resection candidates at increased risk for complications. Chest 1995;108(2):341–348.PubMedCrossRefGoogle Scholar
  47. 47.
    British Thoracic Society, Society of Cardiothoracic Surgeons of Great Britain, Ireland Working Party. Guidelines on the selection of patients with lung cancer. Thorax 2001;56:89–108.CrossRefGoogle Scholar
  48. 48.
    Kvale P, Ranga V, Kopacz M, Cox F, Magalligan D, Davila J. Pulmonary resection. South Med J 1977;70(Suppl 1):64–69.PubMedGoogle Scholar
  49. 49.
    Truesdale R, D’Alessandri R, Manuel V, Daicoff G, Kluge RM. Antimicrobial vs. placebo prophylaxis in noncardiac thoracic surgery. JAMA 1979;241(12):1254–1256.PubMedCrossRefGoogle Scholar
  50. 50.
    Cameron JL, Imbembo A, Kieffer RF, Spray S, Baker RR. Prospective clinical-trial of antibiotics for pulmonary resections. Surg Gynecol Obstet 1981;152(2):156–158.PubMedGoogle Scholar
  51. 51.
    Lancon JP, Caillard B, Coulon C, Beaulieu C, Viard H. Postoperative complications of pulmonary surgery. Lyon Chirurg 1986;82(1):14–17.Google Scholar
  52. 52.
    lives R, Cooper JD, Todd TRJ, Pearson FG. Prospective, randomized, double-blind study using prophylactic cephalothin for major, elective, general thoracic operations. J Thorac Cardiovasc Surg 1981;81(6):813–817.Google Scholar
  53. 53.
    Olak J, Jeyasingham K, Forrester-Wood C, Hutter J, al-Zeerah M, Brown E. Randomized trial of one-dose versus six-dose cefazolin prophylaxis in elective general thoracic surgery. Ann Thor Surg 1991;51(6):956–958.CrossRefGoogle Scholar
  54. 54.
    Wertzel H, Swoboda L, Jooswurtemberger A, Frank U, Hasse J. Perioperative antibiotic-prophylaxis in general thoracic-surgery. Thorac and Cardiovas Surg 1992;40(6):326–329.CrossRefGoogle Scholar
  55. 55.
    Bernard A, Pillet M, Goudet P, Viard H. Antibiotic-Prophylaxis in pulmonary surgery: a prospective randomized double-blind trial of flash cefuroxime versus 48-hour cefuroxime. J Thorac Cardiovas Surg 1994;107(3):896–900.Google Scholar
  56. 56.
    Boulanger A, Choiniere M, Roy D, et al. Comparison between patient-controlled analgesia and intramuscular meperidine after thoracotomy. Can J Anaesth 1993;40(5 pt 1):409–415.PubMedGoogle Scholar
  57. 57.
    Etches RC, Gammer TL, Cornish R. Patient-controlled epidural analgesia after thoracotomy: a comparison of meperidine with and without bupivacaine. Anesth Analg 1996;83(1):81–86.PubMedCrossRefGoogle Scholar
  58. 58.
    Grant RP, Dolman JF, Harper JA, et al. Patient-controlled lumbar epidural fentanyl compared with patient-controlled intravenous fentanylforpost-thoracotomypain. Can J Anaesth 1992;39(3):214–219.PubMedCrossRefGoogle Scholar
  59. 59.
    Smythe M. Patient-controlled analgesia: a review. Phamaco-therapy 1992;12(2):132–143.Google Scholar
  60. 60.
    Senturk M, Ozcan PE, Talu GK, et al. The effects of three different analgesia techniques on long-term postthoracotomy pain. Anesth Analg 2002;94(1):11–15, table.PubMedCrossRefGoogle Scholar
  61. 61.
    Sandler AN. Post-thoracotomy analgesia and perioperative outcome. Minerva Anestesiol 1999;65(5):267–274.PubMedGoogle Scholar
  62. 62.
    Gray JR, Fromme GA, Nauss LA, Wang JK, Ilstrup DM. Intrathecal morphine for post-thoracotomy pain. Anesth Analg 1986;65(8):873–876.PubMedCrossRefGoogle Scholar
  63. 63.
    Alexander R, El Moalem HE, Gan TJ. Comparison of the morphine-sparing effects of diclofenac sodium and ketorolac tromethamine after major orthopedic surgery. J Clin Anesth 2002;14(3):187–192.PubMedCrossRefGoogle Scholar
  64. 64.
    Perttunen K, Nilsson E, Kalso E. IV diclofenac and ketorolac for pain after thoracoscopic surgery. Br J Anaesth 1999;82(2):221–227.PubMedGoogle Scholar
  65. 65.
    Singh H, Bossard RF, White PF, Yeatts RW. Effects of ketorolac versus bupivacaine coadministration during patient-controlled hydromorphone epidural analgesia after thoracotomy procedures. Anesth Analg 1997;84(3):564–569.PubMedCrossRefGoogle Scholar
  66. 66.
    Rhodes M, Conacher I, Morritt G, Hilton C. Nonsteroidal antiinflammatory drugs for postthoracotomy pain. A prospective controlled trial after lateral thoracotomy. J Thorac Cardiovasc Surg 1992;103(1):17–20.PubMedGoogle Scholar
  67. 67.
    Perttunen K, Kalso E, Heinonen J, Salo J. IV diclofenac in postthoracotomy pain. Br J Anaesth 1992;68(5):474–480.PubMedCrossRefGoogle Scholar
  68. 68.
    Cooper JD, Patterson GA. Lung-volume reduction surgery for severe emphysema. Chest Surg Clin N Am 1995;5:815–831.PubMedGoogle Scholar
  69. 69.
    Marshall MB, Deeb ME, Bleier JIS, et al. Suction vs. waterseal after pulmonary resection. Chest 2002;121(3):831–835.PubMedCrossRefGoogle Scholar
  70. 70.
    Cerfolio RJ, Bass C, Katholi CR. Prospective randomized trial compares suction versus water seal for air leaks. Ann Thorac Surg 2001;71(5):1613–1617.PubMedCrossRefGoogle Scholar
  71. 71.
    Zehr KJ, Dawson PB, Yang SC, Heitmiller RF. Standardized clinical care pathways for major thoracic cases reduce hospital costs. Ann Thorac Surg 1998;66(3):914–919.PubMedCrossRefGoogle Scholar
  72. 72.
    Wright CD, Wain JC, Grillo HC, Moncure AC, Macaluso SM, Mathisen DJ. Pulmonary lobectomy patient care pathway: a model to control cost and maintain quality. Ann Thorac Surg 1997;64(2):299–302.PubMedCrossRefGoogle Scholar
  73. 73.
    Ziomek S, Read RC, Tobler HG, Harrell JE, Gocio JC, Fink LM, et al. Thromboembolism in patients undergoing thoracotomy. Ann Thorac Surg 1993;56(2):223–227.PubMedCrossRefGoogle Scholar
  74. 74.
    Schunemann HJ, Cook D, Grimshaw J, et al. Antithrombotic and thrombolytic therapy: from evidence to application: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 2004;126(3S):688S–696S.PubMedCrossRefGoogle Scholar
  75. 75.
    Heit JA, Petterson TM, Marks RS, Bailey KR, Melton LJ. The risk of venous thromboembolism (VTE) among cancer patients by tumor site: a population-based study. Blood 2004;104(11):711A.Google Scholar
  76. 76.
    Kalweit G, Huwer H, Volkmer I, Petzold T, Gams E. Pulmonary embolism: a frequent cause of acute fatality after lung resection. Eur J Cardiothorac Surg 1996;10(4):242–246.PubMedCrossRefGoogle Scholar
  77. 77.
    Nagahiro I, Andou A, Aoe M, Sano Y, Date H, Shimizu N. Intermittent pneumatic compression is effective in preventing symptomatic pulmonary embolism after thoracic surgery. Surg Today 2004;34(1):6–10.PubMedCrossRefGoogle Scholar
  78. 78.
    Amar D, Burt M, Reinsel RA, Leung DH. Relationship of early postoperative dysrhythmias and long-term outcome after resection of non-small cell lung cancer. Chest 1996;110(2):437–439.PubMedCrossRefGoogle Scholar
  79. 79.
    Ritchie AJ, Whiteside M, Tolan M, McGuigan JA. Cardiac dysrhythmia in total thoracic oesophagectomy. A prospective study. Eur J Cardiothorac Surg 1993;7(8):420–422.PubMedCrossRefGoogle Scholar
  80. 80.
    Polanczyk CA, Goldman L, Marcantonio ER, Orav EJ, Lee TH. Supraventricular arrhythmia in patients having noncardiac surgery: clinical correlates and effect on length of stay. Ann Intern Med 1998;129(4):279–285.PubMedGoogle Scholar
  81. 81.
    Todd TRJ, Ralph-Edwards AC. Perioperative management. In: Pearson FG, Cooper JD, Deslauries J, Ginsberg RJ, Hiebert CA, Patterson GA, eds. Thoracic Surgery. New York: Livingstone, 2002.Google Scholar
  82. 82.
    Jakobsen CJ, Bille S, Ahlburg P, Rybro L, Hjortholm K, Andresen EB. Perioperative metoprolol reduces the frequency of atrial fibrillation after thoracotomy for lung resection. J Cardiothorac Vasc Anesth 1997;11(6):746–751.PubMedCrossRefGoogle Scholar
  83. 83.
    Amar D, Roistacher N, Burt M, Reinsel RA, Ginsberg RJ, Wilson RS. Clinical and echocardiographic correlates of symptomatic tachydysrhythmias after noncardiac thoracic surgery. Chest 1995;108(2):349–354.PubMedCrossRefGoogle Scholar
  84. 84.
    Backlund M, Laasonen L, Lepantalo M, Metsarinne K, Tikkanen I, Lindgren L. Effect of oxygen on pulmonary hemodynamics and incidence of atrial fibrillation after noncardiac thoracotomy. J Cardiothorac Vasc Anesth 1998;12(4):422–428.PubMedCrossRefGoogle Scholar
  85. 85.
    Vaporciyan AA, Correa AM, Rice DC, et al. Risk factors associated with atrial fibrillation after noncardiac thoracic surgery: analysis of 2588 patients. J Thorac Cardiovasc Surg 2004;127(3):779–786.PubMedCrossRefGoogle Scholar
  86. 86.
    Bayliff CD, Massel DR, Inculet RI, et al. Propranolol for the prevention of postoperative arrhythmias in general thoracic surgery. Ann Thorac Surg 1999;67(1):182–186.PubMedCrossRefGoogle Scholar
  87. 87.
    Ritchie AJ, Tolan M, Whiteside M, McGuigan JA, Gibbons JR. Prophylactic digitalization fails to control dysrhythmia in thoracic esophageal operations. Ann Thorac Surg 1993;55(1):86–88.PubMedCrossRefGoogle Scholar
  88. 88.
    Ritchie AJ, Bowe P, Gibbons JR. Prophylactic digitalization for thoracotomy: a reassessment. Ann Thorac Surg 1990;50(1):86–88.PubMedCrossRefGoogle Scholar
  89. 89.
    Kaiser A, Zund G, Weder W, Largiader F. Preventive digitalis therapy in open thoracotomy. Helv Chir Acta 1994;60(6):913–917.PubMedGoogle Scholar
  90. 90.
    Ritchie AJ, Danton M, Gibbons JR. Prophylactic digitalisation in pulmonary surgery. Thorax 1992;47(1):41–43.PubMedCrossRefGoogle Scholar
  91. 91.
    Van Mieghem W, Coolen L, Malysse I, Lacquet LM, Deneffe GJ, Demedts MG. Amiodarone and the development of ARDS after lung surgery. Chest 1994;105(6):1642–1645.PubMedCrossRefGoogle Scholar
  92. 92.
    Chung MK. Cardiac surgery: postoperative arrhythmias. Crit Care Med 2000;28(10 suppl):N136–N144.PubMedCrossRefGoogle Scholar
  93. 93.
    Basta M, Klein GJ, Yee R, Krahn A, Lee J. Current role of pharmacologic therapy for patients with paroxysmal supraventricular tachycardia. Cardiol Clin 1997;15(4):587–597.PubMedGoogle Scholar
  94. 94.
    Ferguson JD, DiMarco JP. Contemporary management of paroxysmal supraventricular tachycardia. Circulation 2003;107(8):1096–1099.PubMedCrossRefGoogle Scholar
  95. 95.
    Solomon AJ. Treatment of postoperative atrial fibrillation: a nonsurgical perspective. Semin Thorac Cardiovasc Surg 1999;11(4):320–324.PubMedGoogle Scholar
  96. 96.
    Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82(8A):2N–9N.PubMedCrossRefGoogle Scholar
  97. 97.
    Frimodt Moller N, Ostri P, Pedersen IK, Poulsen SR. Antibiotic-prophylaxis in pulmonary surgery: a double-blind study of penicillin versus placebo. Ann Surg 1982;195(4):444–450.PubMedGoogle Scholar
  98. 98.
    Tarkka M, Pokela R, Lepojarvi M, Nissinen J, Karkola P. Infection prophylaxis in pulmonary surgery: a randomized prospective study. Ann Thorac Surg 1987;44(5):508–513.PubMedGoogle Scholar
  99. 99.
    Anzar R, Mateu M, Miro J. Antibiotic prophylaxis in non-cardiac thoracic surgery: cefazolin versus placebo. Eur J Cardiothorac Surg 1991;5:515–518.CrossRefGoogle Scholar
  100. 100.
    Krasnik M, Thiis J, Frimodtmoller N. Antibiotic prophylaxis in noncardiac thoracic surgery: a double-blind study of penicillin vs. cefuroxime. Scand J Thorac Cardiovasc Surg 1991;25(1):73–76.PubMedGoogle Scholar
  101. 101.
    Boldt J, Piper S, Uphus D, Fussle R, Hempelmann G. Preoperative microbiologic screening and antibiotic prophylaxis in pulmonary resection operations. Ann Thorac Surg 1999;68(1):208–211.PubMedCrossRefGoogle Scholar
  102. 102.
    Turna A, Kutlu CA, Ozalp T, Karamustafaoglu A, Mulazimoglu L, Bedirhan MA. Antibiotic prophylaxis in elective thoracic surgery: cefuroxime vs. cefepime. Thorac Cardiovasc Surg 2003;51(2):84–88.PubMedCrossRefGoogle Scholar
  103. 103.
    Amar D, Roistacher N, Rusch VW, et al. Effects of diltiazem prophylaxis on the incidence and clinical outcome of atrial arrhythmias after thoracic surgery. J Thorac Cardiovasc Surg 2000;120(4):790–798.PubMedCrossRefGoogle Scholar
  104. 104.
    Lindgren L, Lepantalo M, von Knorring J, Rosenberg P, Orko R, Scheinin B. Effect of verapamil on right ventricular pressure and atrial tachyarrhythmia after thoracotomy. Br J Anaesth 1991;66(2):205–211.PubMedCrossRefGoogle Scholar
  105. 105.
    Van Mieghem W, Tits G, Demuynck K, et al. Verapamil as prophylactic treatment for atrial fibrillation after lung operations. Ann Thorac Surg 1996;61(4):1083–1085.PubMedCrossRefGoogle Scholar
  106. 106.
    Terzi A, Furlan G, Chiavacci P, Dal Corso B, Luzzani A, Dalla VS. Prevention of atrial tachyarrhythmias after non-cardiac thoracic surgery by infusion of magnesium sulfate. Thorac Cardiovasc Surg 1996;44(6):300–303.PubMedCrossRefGoogle Scholar
  107. 107.
    Borgeat A, Biollaz J, Bayer-Berger M, Kappenberger L, Chapuis G, Chiolero R. Prevention of arrhythmias by flecainide after noncardiac thoracic surgery. Ann Thorac Surg 1989;48(2):232–234.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Jessica Scott Donington
    • 1
  1. 1.Department of Cardiothoracic SurgeryStanford University Medical CenterStanfordUSA

Personalised recommendations