Skip to main content
SpringerLink
Log in

Postoperative Respiratory Management

  • Conference paper
Intensive Care Medicine

  • 336 Accesses

Abstract

Optimal postoperative respiratory management relies on adequate preoperative risk reduction and medical optimization if necessary in patients undergoing elective procedures. The goals of management in elective patients is to reduce the risk of postoperative pulmonary complications including: nosocomial pneumonia, atelectasis, prolonged ventilatory support, and acute respiratory distress syndrome (ARDS). With adequate screening of patients along with emphasis on smoking cessation and vigilant pulmonary care in the postoperative period the risk of these complications can be reduced.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hall JC, Tarala RA, Hall JL (1996) Respiratory insufficiency after abdominal surgery. Respirology 1: 133–138

    Article  PubMed  CAS  Google Scholar 

  2. Arozullah AM, Khuri SF, Henderson WG, et al (2001) Development and validation of a multifactorial risk index for predicting post-operative pneumonia after major noncardiac surgery. Ann Intern Med 135: 847–857

    Article  PubMed  CAS  Google Scholar 

  3. Martin LF, Atnip RG, Holmes PA, et al (1994) Prediction of post-operative complications after elective aortic surgery using stepwise logistic regression analysis. Am Surg 60: 163–168

    PubMed  CAS  Google Scholar 

  4. Fisher BW, Majumdar SR, McAlister FA (2002) Predicting pulmonary complications after nonthoracic surgery: a systematic review of blinded studies. Am J Med 112: 219–225

    Article  PubMed  Google Scholar 

  5. Brooks-Brunn JA (1997) Predictors of post-operative pulmonary complications following abdominal surgery. Chest 111: 564–571

    Article  PubMed  CAS  Google Scholar 

  6. Mitchell CK, Smoger SH, Pfeifer MP, et al (1998) Multivariate analysis of factors associated with post-operative pulmonary complications following general elective surgery. Arch Surg 133: 194–198

    Article  PubMed  CAS  Google Scholar 

  7. Trayner E, Celli BR (2001) Postoperative pulmonary complications. Med Clin North Am 85: 1129–1139

    Article  PubMed  Google Scholar 

  8. Engoren M, Buderer NF, Zacharias A, et al (1999) Variables predicting reintubation after cardiac surgery. Ann Thorac Surg 67: 661–665

    Article  PubMed  CAS  Google Scholar 

  9. Vaporciyan AA, Merriman KW, Ece F, et al (2002) Incidence of major pulmonary morbidity after pneumonectomy: association with timing of smoking cessation. Ann Thorac Surg 73: 420–426

    Article  PubMed  Google Scholar 

  10. Hayden SP, Mayer ME, Stoller JK (1995) Post-operative pulmonary complications: risk assessment, prevention, and treatment. Cleve Clin J Med 62: 401–407

    PubMed  CAS  Google Scholar 

  11. Zibrak JD, O’Donnell CR (1993) Indications for pre-operative pulmonary function testing. Clin Chest Med 14: 227–236

    PubMed  CAS  Google Scholar 

  12. Lawrence VA, Dhanda R, Hilsenbeck SG (1996) Risk of pulmonary complications after elective abdominal surgery. Chest 110: 744–750

    Article  PubMed  CAS  Google Scholar 

  13. Smetana GW (1999) Pre-operative pulmonary evaluation. N Engl J Med 340: 937–944

    Article  PubMed  CAS  Google Scholar 

  14. No author listed (1968) The post-operative chest. Br Med J 2: 713–714

    Google Scholar 

  15. Ferguson MK (1999) Pre-operative assessment of pulmonary risk. Chest 115: 58S - 63S

    Article  PubMed  CAS  Google Scholar 

  16. Milot J, Perron J, Lacasse Y, et al (2001) Incidence and predictors of ARDS after cardiac surgery. Chest 119: 884–888

    Article  PubMed  CAS  Google Scholar 

  17. Payne M, Magovern GJ, Benckart DH, et al (2002) Left pleural effusion after coronary artery bypass decreases with a supplemental pleural drain. Ann Thorac Surg 73: 149–152

    Article  PubMed  Google Scholar 

  18. Douglas JM, Spaniol S (2002) Prevention of post-operative pneumothorax in patients undergoing cardiac surgery Am J Surg 183: 551–553

    Google Scholar 

  19. Fillinger MP, Yeager MP, Dodds TM, et al (2002) Epidural anesthesia and analgesia: effects on recovery from cardiac surgery. J Cardiothorac Vasc Anesth. 16: 15–20

    Article  PubMed  Google Scholar 

  20. Svensson LG, Hess KR, Coselli JS, et al (1991) A prospective study of respiratory failure after high-risk surgery on the thoracoabdominal aorta. J Vasc Surg 14: 271–282

    Article  PubMed  CAS  Google Scholar 

  21. Jayr C, Matthay MA, Goldstone J, et al (1993) Pre-operative and intraoperative factors associated with prolonged mechanical ventilation. A study in patients following major abdominal vascular surgery. Chest 103: 1231–1236

    Article  PubMed  CAS  Google Scholar 

  22. Dunne JR, Malone D, Tracy JK, et al (2002) Peri-operative anemia: an independent risk factor for infection, mortality, and resource utilization in surgery. J Surg Res 102: 237–244

    Article  PubMed  Google Scholar 

  23. Hedenstierna G (2002) Airway closure, atelectasis and gas exchange during anaesthesia. Minerva Anestesiol 68: 332–336

    PubMed  CAS  Google Scholar 

  24. Hall JC, Tarala RA, Tapper J, et al (1996) Prevention of respiratory complications after abdominal surgery: a randomized clinical trial. Br Med J 312: 148–152

    Article  CAS  Google Scholar 

  25. Doyle RL (1999) Assessing and modifying the risk of post-operative pulmonary complications. Chest 115: 77S - 81S

    Article  PubMed  CAS  Google Scholar 

  26. Rowe S, Cheadle WG (2000) Complications of nosocomial pneumonia in the surgical patient. Am J Surg 179 (Suppl 2A): 63S - 68S

    Article  PubMed  CAS  Google Scholar 

  27. Croce MA (2000) Post-operative pneumonia. Am Surg 66: 133–137

    PubMed  CAS  Google Scholar 

  28. Dimick JB, Swoboda SM, Pronovost PJ, et al (2001) Effect of nurse-to-patient ratio in the intensive care unit on pulmonary complications and resource use after hepatectomy. Am J Crit Care 10: 376–382

    PubMed  CAS  Google Scholar 

  29. Brooks JA (2001) Post-operative nosocomial pneumonia: nurse sensitive interventions. AACN Clinical Issues 12: 305–323

    Article  PubMed  CAS  Google Scholar 

  30. Kollef MH (1993)Ventilator associated pneumonia: a multivariate analysis. JAMA 270:1965–1970

    Google Scholar 

  31. Koss WG, Khalili TM, Lemus JF, et al (2001) Nosocomial pneumonia is not prevented by contact isolation in the surgical intensive care unit. Am Surg 67: 1140–1144

    PubMed  CAS  Google Scholar 

  32. Kollef MH, Von Harz B, Prentice D, et al (1997) Patient transport from intensive care increases the risk of developing vetilator-associated pneumonia. Chest 112: 765–773

    Article  PubMed  CAS  Google Scholar 

  33. de Lassence A, Alberti C, Azoulay E, et al (2002) Impact of unplanned extubation and reintubation after weaning on nosocomial pneumonia risk in the intensive care unit. Anesthesiology 97: 148–156

    Article  PubMed  Google Scholar 

  34. Smulders K, van der Hoeven H, Weers-Pothoff I, et al (2002) A randomized clinical trial of intermittent subglottic secretion drainage in patients receiving mechanical ventilation. Chest 121: 858–862

    Article  PubMed  Google Scholar 

  35. Kollef MH, Skubas NJ, Sundt TM (1999) A randomized clinical trial of continuous aspiration of subglottic secretions in cardiac surgery patients. Chest 116: 1339–1346

    Article  PubMed  CAS  Google Scholar 

  36. Montravers P, Veber B, Auboyer C (2002) Diagnostic and therapeutic management of nosocomial pneumonia in surgical patients: results of the Eole study. Crit Care Med 30: 368–375

    Article  PubMed  Google Scholar 

  37. Burchard KW, Gann DS, Wiles CE (2000) The Pulmonary System. In: The Clinical Handbook for Surgical Critical Care, Parthenon Publishing Group, New York, pp 103–159

    Google Scholar 

  38. The ARDS Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000 342: 1301–1308

    Article  Google Scholar 

  39. Klinger JR (2002) Inhaled nitric oxide in ARDS. Crit Care Clin 18: 45–68

    Article  PubMed  CAS  Google Scholar 

  40. Pelosi P, Brazzi L, Gattinoni L (2002) Prone positioning in acute respiratory distress syndrome. Eur Respir J 20: 1017–1028

    Article  PubMed  CAS  Google Scholar 

  41. Grasso S, Mascia L, Del Turco M, et al (2002) Effects of recruiting maneuvers in patients with acute respiratory distress syndrome ventilated with protective ventilatory strategy. Anesthesiology 96: 795–802

    Article  PubMed  Google Scholar 

Download references

Authors
  1. G. K. Albaugh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. P. Dellinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent MD, PhD, FCCM, FCCP (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Albaugh, G.K., Dellinger, R.P. (2003). Postoperative Respiratory Management. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-5548-0_36

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-5548-0_36

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-5550-3

  • Online ISBN: 978-1-4757-5548-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation