Skip to main content

Peri-Operative Risk Factors for Post-Operative Pulmonary Complications

  • Conference paper
  • 215 Accesses

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1999))

Abstract

Pulmonary complications, such as atelectasis, productive cough and pneumonia constitute the major part of post-operative complications. It can be expected that the incidence and severity of post-operative pulmonary complications will increase in the future, as an increasing number of patients with significant co-morbidities will have to undergo surgery. The advent of advanced monitoring techniques and treatment has enabled major surgery even in severely ill and debilitated patients. This practice will increase the need for intensified post-operative care and artificial respiratory support.

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

Buying options

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

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

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

    Article  PubMed  CAS  Google Scholar 

  2. Jayr C, Matthay MA, Goldstone, et al (1993) Preoperative and intraoperative factors associated with prolonged mechanical ventilation. Chest 103:1231–1236.

    Article  PubMed  CAS  Google Scholar 

  3. Craig DB (1981) Postoperative recovery of pulmonary function. Anesth Analg 60:46–52.

    PubMed  CAS  Google Scholar 

  4. Fairley HB (1980) Oxygen therapy for surgical patients. Am Rev Respir Dis 122:37–44.

    PubMed  CAS  Google Scholar 

  5. Celli BR (1993) Perioperative respiratory care of the patient undergoing upper abdominal surgery. Clin Chest Med 14:253–261.

    PubMed  CAS  Google Scholar 

  6. Warner MA, Divertie MB, Tinker JH (1984) Preoperative cessation of smoking and pulmonary complications in coronary artery bypass patients. Anesthesiology 60:380–383.

    Article  PubMed  CAS  Google Scholar 

  7. Buiste AS, Sexton GJ, Nagy JM, et al (1976) The effect of smoking cessation and modification on lung function. Am Rev Respir Dis 114:115–122.

    Google Scholar 

  8. Mitchell C, Garrahy P, Peake P (1982) Postoperative respiratory morbidity: identification and risk factors. Aust NZ J Surg 52:203–209.

    Article  CAS  Google Scholar 

  9. Bode FR, Dosman J, Martin RR, Macklem PT (1975) Reversibility of pulmonary function abnormalities in smokers. Am J Med 59:43–52.

    Article  PubMed  CAS  Google Scholar 

  10. Tisi GM (1979) Preoperative evaluation of lung function. Am Rev Respir Dis 119:293–310.

    PubMed  CAS  Google Scholar 

  11. Jackson CV (1988) Preoperative pulmonary evaluation. Arch Intern Med 148:2120–2127.

    Article  PubMed  CAS  Google Scholar 

  12. Mohr DH, Jett JR (1988) Preoperative evaluation of pulmonary risk factors. J Gen Intern Med 3:277–287.

    Article  PubMed  CAS  Google Scholar 

  13. Kroenke K, Lawrence VA, Theroux JF, et al (1993) Postoperative complications after thoracic and major abdominal surgery in patients with and without obstructive lund disease. Chest 104: 1445–1451.

    Article  PubMed  CAS  Google Scholar 

  14. Gold MI, Helrich M (1963) A study of the complications related to to anesthesia in asthmatic patients. Anesth Analg 42:283–293.

    Article  Google Scholar 

  15. Hodgkin JE, Dines DE, Didier EP (1973) Preoperative evaluation of the patient with pulmonary disease. Mayo Clin Proc 48:14–18.

    Google Scholar 

  16. Oh SH, Patterson R (1974) Surgery in corticosteroid-dependent asthmatics. J Allergy Clin Immunol 53:345–351.

    Article  PubMed  CAS  Google Scholar 

  17. Pasulka PS, Bistrian BR, Benotti PN, et al (1986) The risks of surgery in obese patients. Ann Intern Med 104:540–546.

    PubMed  CAS  Google Scholar 

  18. Vaughan RW, Engelhart RC, Wise L (1974) Postoperative hypoxemia in obese patients. Ann Surg 180:877–882.

    Article  PubMed  CAS  Google Scholar 

  19. Didolkar MS, Moore RH, Takita H (1974) Evaluation of the risk in pulmonary resection for bronchogenic carcinoma. Am J Surg 127:700–703.

    Article  PubMed  CAS  Google Scholar 

  20. Yellin A, Benfield JR (1985) Surgery for bronchogenic carcinoma in the elderly. Am Rev Respir Dis 131:197.

    PubMed  CAS  Google Scholar 

  21. Wolfe BM, Moore PG (1993) Preparation of the intensive care patient for major surgery. World J Surg 17:184–191.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  23. Kroenke K, Lawrence VA, Theroux JF, Tuley MR (1992) Operative risk in patients with severe obstructive disease. Arch Intern Med 152:967–971.

    Article  PubMed  CAS  Google Scholar 

  24. Gerson MC, Hurst JM, Hertzberg VS, et al (1990) Prediction of cardiac or pulmonary complications related to elective abdominal and noncardiac surgery in geriatric patients. Am J Med 88:101–107.

    Article  PubMed  CAS  Google Scholar 

  25. Wong DH, Weber EC, Schell MJ, Wong AB (1995) Factors associated with postoperative pulmonary complications in patients with severe chronic obstructive pulmonary disease. Anesth Analg 80:276–284.

    PubMed  CAS  Google Scholar 

  26. Gass GD, Olsen GN (1986) Preoperative pulmonary function testing to predict postoperative morbidity and mortality. Chest 89:127–135.

    Article  PubMed  CAS  Google Scholar 

  27. Hnatiuk OW, Dillard TA, Torrington KG (1995) Adherence to established guidelines for preoperative pulmonary function testing. Chest 107:1294–1297.

    Article  PubMed  CAS  Google Scholar 

  28. Stein M, Cassara EL (1970) Preoperative pulmonary evaluation and therapy for surgery. JAMA 211:787–790.

    Article  PubMed  CAS  Google Scholar 

  29. Nomori H, Kobayashi R, Fuyuno G, et al (1994) Preoperative muscle training. Chest 105: 1782–1788.

    Article  PubMed  CAS  Google Scholar 

  30. Tarhan S, Moffitt EA, Sessler AD, et al (1973) Risk of anesthesia and surgery in patients with chronic obstructive pulmonary disease. Surgery 74:720–726.

    PubMed  CAS  Google Scholar 

  31. Grant RP, Dolman JF, Harper JA, et al (1990) Patient controlled lumbar epidural fentanyl for post thoracotomy pain. Can J Anaesth 37: S45 (Abst).

    PubMed  CAS  Google Scholar 

  32. Ueo H, Takeuchi H, Arinaga S, et al (1994) The feasibility of epidural anesthesia without endotracheal intubation for abdominal surgery in patients over 80 years of age. Int Surg 79:158–162.

    PubMed  CAS  Google Scholar 

  33. Nakashima H, Ueo H, Takeuchi H, Arinaga S, et al (1995) Pancreaticoduodenectomy under epidural anesthesia without endotracheal intubation for the elderly. Int Surg 80:125 127.

    PubMed  CAS  Google Scholar 

  34. Jayr C, Thomas H, Rey A, Farhat F, Lasser P, Bourgain JL (1993) Postoperative pulmonary complications, epidural analgesia using bupivacaine and opioids versus parenteral opioids. Anesthesiology 78:666–676.

    Article  PubMed  CAS  Google Scholar 

  35. Parfrey PS, Harte PJ, Quinlan JP, et al (1977) Pulmonary function in the early postoperative period. Br J Surg 64:384 389.

    Article  PubMed  CAS  Google Scholar 

  36. Hoffman WD, Natanson C (1993) Pulmonary complications of anesthesia. In: Rogers MC, Tinker JH, Covino BF, Congnecker DE (eds) Principles and practice of anesthesiology. Mosby, St Louis, pp 2401–2410.

    Google Scholar 

  37. Dureuil B, Viires N, Cantineau JP, et al (1986) Diaphragmatic contractility after abdominal surgery. J Appl Physiol 61:1775–1780.

    PubMed  CAS  Google Scholar 

  38. Gaensler EA, Cugell D, Lindgren I, et al (1959) The role of pulmonary insufficiency in mortality and invalidism following surgery for pulmonary tuberculosis. J Thorac Surg 29:163–187.

    Google Scholar 

  39. Julian OC, Lopez-Belio M, Dye WS (1957) The median sternal incision in intracardiac surgery with extracorporeal circulation: a general evaluation of its use in heart surgery. Surgery 42:753–761.

    PubMed  CAS  Google Scholar 

  40. Tammeling G, Lanos C (1959) An analysis of the pulmonary function of ninety patients following pulmectomy for pulmonary tuberculosis. J Thorac Surg 37:148–165.

    PubMed  CAS  Google Scholar 

  41. Halasz NA (1964) Vertical versus horizontal laparotomies. Arch Surg 88:911–914.

    Article  PubMed  CAS  Google Scholar 

  42. Vaughan RW, Wise L (1975) Choice of abdominal operative incision in the obese patient. Ann Surg 181:829–835.

    Article  PubMed  CAS  Google Scholar 

  43. Sicard GA, Reilly JM, Rubin BG, et al (1995) Transabdominal versus retroperitoneal incision for abdominal aortic surgery: Report of a prospective randomized trial. J Vasc Surg 21:174–183.

    Article  PubMed  CAS  Google Scholar 

  44. Rousou JA, Parker T, Engelman RM, Breyer RH (1985) Phrenic nerve paresis associated with the use of ice slush and the cooling jacquet for topical hypothermia. J Thorax Cardiovasc Surg 89:921–925.

    CAS  Google Scholar 

  45. Ali J, Weisel RD, Layug AB, et al (1974) Consequences of postoperative alterations in respiratory mechanics. Am J Surg 128:376–382.

    Article  PubMed  CAS  Google Scholar 

  46. Meyers JR, Lembeck L, O’Kane H, et al (1975) Changes in functional residual capacity of the lung after operation. Arch Surg 110:576 583.

    Article  PubMed  CAS  Google Scholar 

  47. Latimer RG, Dickman M, Day WC, et al (1971) Ventilatory patterns and pulmonary complications after upper abdominal surgery determined by preoperative and postoperative computerized spirometry and blood gas analysis. Am J Surg 122:622–632.

    Article  PubMed  CAS  Google Scholar 

  48. Feig BW, Berger DH, Dougherty TB (1994) Pharmacologic intervention can re-establish baseline hemodynamic parameters during laparoscopy. Surgery 116:733–741.

    PubMed  CAS  Google Scholar 

  49. Sharma KC, Brandstetter RD, Brensilver JM, Jung LD (1996) Cardiopulmonary physiology and pathophysiology as a consequence of laparoscopic surgery. Chest 110:810–815.

    Article  PubMed  CAS  Google Scholar 

  50. Frazee R, Roberts JW, Okeson GC, et al (1991) Open versus laparoscopic cholecystectomy: a comparison of postoperative pulmonary function. Ann Surg 213:651–654.

    Article  PubMed  CAS  Google Scholar 

  51. Putensen-Himmer G, Putensen C, Lammer H, Lingnau W, Aigner F, Benzer H (1992) Comparison of postoperative respiratory function after laparoscopy or open laparotomy for cholecystectomy. Anesthesiology 77:675–680.

    Article  PubMed  CAS  Google Scholar 

  52. Safran D (1995) Volume expansion is an effective intervention during laparoscopy. Surgery 118:574–575.

    Article  PubMed  CAS  Google Scholar 

  53. Lowell JA, Schifferdecker C, Driscoll DF, et al (1990) Postoperative fluid overload: Not a benign problem. Crit Care Med 18:728–733.

    Article  PubMed  CAS  Google Scholar 

  54. Bigatello LM, Wilson RS (1994) Medical problems in surgical patients: Respiratory problems. In: Morris PJ, Malt RA (eds) Oxford Textbook of Surgery volume 1. Oxford University Press, Oxford, pp 167–177.

    Google Scholar 

  55. Bion JF, Ledingham I McA (1987) Sedation in the intensive care unit — a postal survey. Intensive Care Med 13:218–219.

    Google Scholar 

  56. Burns M, Shelly MP, Park GR (1992) The use of sedative agents in critically ill patients. Drugs 43:507–515.

    Article  PubMed  CAS  Google Scholar 

  57. Manara AR, Bodemham AR, Park GR (1990) Analgesic efficacy of perioperative buccal morfine. Br J Anaesth 64:551–555.

    Article  PubMed  CAS  Google Scholar 

  58. Kilbride MJ, Senagore AJ, Mazier WP, Ferguson C, Ufkes T (1992) Epidural analgesia. Surg Gyn Obs 174:137–140.

    CAS  Google Scholar 

  59. Yeager MP, Glass DD, Neff RK, Brinck-Johnsen T (1987) Epidural anesthesia and analgesia in high risk surgical patients. Anesthesiology 66:729–736.

    Article  PubMed  CAS  Google Scholar 

  60. Horan TC, White JW, Jarvis WR, et al (1993) National nosocomial infections surveillance system. Nosocomial infection in surgical patients in the United States. January 1986–June 1992. Infect Control Hosp Epidemiol 14:73–80.

    Article  PubMed  CAS  Google Scholar 

  61. Garibaldi RA, Britt MR, Coleman ML, et al (1981) Risk factors for postoperative pneumonia. Am J Med 70:677–680.

    Article  PubMed  CAS  Google Scholar 

  62. Cunnion KM, Weber DJ, Broadhead WE, et al (1996) Risk factors for nosocomial pneumonia: comparing adult critical-care populations. Am Rev Respir Crit Care Med 153:158–162.

    CAS  Google Scholar 

  63. Dreyfuss D, Djedaini K, Weber P, et al (1991) Prospective study of nosocomial pneumonia and of patient and circuit colonisation during mechanical ventilation with circuit changes every 48 hours versus no change. Am Rev Respir Dis 143:738–743.

    PubMed  CAS  Google Scholar 

  64. Dreyfuss D, Djedaini K, Gros I, et al (1995) Mechanical ventilation with heated humidifiers or heat and moisture exchangers: effect on patient colonisation and incidence of nosocomial pneumonia. Am J Respir Crit Care Med 151:986–992.

    PubMed  CAS  Google Scholar 

  65. Djedaini K, Billiard M, Mier L, et al (1995) Changing heat and moisture exchangers every 48 hours rather than 24 hours does not affect their efficacy and the incidence of nosocomial pneumonia. Am J Respir Crit Care Med 152:1562–1569.

    PubMed  CAS  Google Scholar 

  66. Vandenbroucke-Grauls CMJ, Vandenbroucke JP (1991) Effect of selective decontamination of the digestive tract on respiratory tract infections and mortality in the intensive care unit. Lancet 338:859–862.

    Article  PubMed  CAS  Google Scholar 

  67. Selective decontamination of the digestive tract trialists collaborative group (1993) Meta-analysis of randomized controlled trials of selective decontamination of the digestive tract. Br Med J 307:525–532.

    Article  Google Scholar 

  68. Heyland DK, Cook DJ, Jaeschke R, et al (1994) Selective decontamination of the digestive tract: an overview. Chest 105:1221–1229.

    Article  PubMed  CAS  Google Scholar 

  69. Tetteroo GWM, Wagenvoort JHT, Castelein A, Tilanus HW, Bruining HA (1990) Selective decontamination to reduce gram-negative colonisation and infection after oesophagal resection. Lancet 335:704–707.

    Article  PubMed  CAS  Google Scholar 

  70. Verwaest C, Verhaegen J, Ferdinande P, Schetz M, VandenBerghe G, Verbist L, Lauwers P (1997) Randomized, controlled trial of selective digestive decontamination in 600 mechanically ventilated patients in a multidisciplinary intensive care unit. Crit Care Med 25:63–71.

    Article  PubMed  CAS  Google Scholar 

  71. Camus Y, Delva E, Just B, Lienhart A (1993) Legwarming minimizes core hypothermia during abdominal surgery. Anesth Analg 77:995–999.

    Article  PubMed  CAS  Google Scholar 

  72. Yoshioka T, Shires GT, Fantini GA (1992) Hypothermia relieves oxidative stress in reperfused skeletal muscle following partial ischemia. J Surg Res 53:408–416.

    Article  PubMed  CAS  Google Scholar 

  73. Donovan TJ, Muhkerji B, Owens G (1975) Myocardial perfusion and metabolism at normothermic and hypothermic levels. Arch Surg 110:208–210.

    Article  PubMed  CAS  Google Scholar 

  74. Slotman GJ, Jed EH, Burchard KW (1985) Adverse effects of hypothermia in postoperative patients. Am J Surg 149:495–501.

    Article  PubMed  CAS  Google Scholar 

  75. Frank SM, Beattie C, Christopherson R, et al (1992) Epidural versus general anesthesia, ambient. Anesthesiology 77:252–257.

    Article  PubMed  CAS  Google Scholar 

  76. Sessler DI, Sessler AM, Hudson S, Moayeri A (1993) Heat loss during surgical skin preparation. Anesthesiology 78:1055–1064.

    Article  PubMed  CAS  Google Scholar 

  77. Morris RH (1971) Influence of ambient temperature on patient temperature during intraabdominal surgery. Ann Surg 173:230–233.

    Article  PubMed  CAS  Google Scholar 

  78. ACCP Consensus Conference (1993) Mechanical ventilation. Chest 104:1833–1859.

    Article  Google Scholar 

  79. Hess DR, Kacmarek RM (1996) Weaning from mechanical ventilation. In: Hess DR, Kacmarek RM (eds) Essentials of mechanical ventilation. McGraw-Hill, New York, pp 73–74.

    Google Scholar 

  80. Caldwell MTP, Murphy PG, Page R, et al (1993) Timing of extubation after oesophagectomy. Br J Surg 80:1537–1539.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Kanhai, K.J.K., Buijk, S.L.C.E., Bruining, H.A. (1999). Peri-Operative Risk Factors for Post-Operative Pulmonary Complications. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1999. Yearbook of Intensive Care and Emergency Medicine, vol 1999. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-13453-5_50

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-13453-5_50

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-65288-5

  • Online ISBN: 978-3-662-13453-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics