Preoperative Pulmonary Preparation of Patients with Chronic Obstructive Pulmonary Disease

Gracey, Douglas R.; Divertie, Matthew B.; Didier, Edward P.

doi:10.1378/chest.76.2.123

Cited by 175 publications

(32 citation statements)

References 9 publications

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“…Preoperative bronchodilator treatment in patients with COPD results in a decrease in PPC (16,17). Patients should maintain long-term abstinence from cigarette smoking before surgery.…”

Section: Perioperative Coursementioning

confidence: 99%

Anesthetic Considerations in Candidates for Lung Volume Reduction Surgery

Brister

Barnette²,

Kim³

et al. 2008

Proceedings of the American Thoracic Society

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The administration of anesthesia to patients undergoing lung volume reduction surgery (LVRS) requires a complete understanding of the pathophysiology of severe chronic obstructive pulmonary disease, the planned surgical procedure, and the anticipated postoperative course for this group of patients. Risk factors and associated morbidity and mortality are discussed within the context of patients with obstructive pulmonary disease in the National Emphysema Treatment Trial having surgical procedures. Preoperative evaluation and the anesthetic techniques used for patients undergoing LVRS are reviewed, as are monitoring requirements. Intraoperative events, including induction of anesthesia, lung isolation, management of fluid requirements, and options for ventilatory support are discussed. Possible intraanesthetic complications are also reviewed, as is the optimal management of such problems, should they occur. To minimize the potential for a surgical air leak in the postoperative period, positive-pressure ventilation must cease at the conclusion of the procedure. An awake, comfortable, extubated patient, capable of spontaneous ventilation, is only possible if there is careful attention to pain control. The thoracic epidural is the most common pain control method used with patients undergoing LVRS procedures; however, other alternative methods are reviewed and discussed.

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“…Preoperative bronchodilator treatment in patients with COPD results in a decrease in PPC (16,17). Patients should maintain long-term abstinence from cigarette smoking before surgery.…”

Section: Perioperative Coursementioning

confidence: 99%

Anesthetic Considerations in Candidates for Lung Volume Reduction Surgery

Brister

Barnette²,

Kim³

et al. 2008

Proceedings of the American Thoracic Society

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show abstract

“…This means, for instance, that with 80% HR max is reached, VO 2 max is at 70% of its maximum. So, for male patients (Table VI Some general and supportive measures, such as quit smoking, respiratory physical therapy, hydration and electrolytic balance, may decrease postoperative complications, such as: atelectasis, pneumonia, respiratory failure and prolonged hospitalization 43,44 . Cigarettes should be abandoned 6 to 8 months before surgery, but their withdrawal for 2 months is enough to increase FEV 1 and improve small airway measures 45 .…”

Section: Exercise Testmentioning

confidence: 99%

Avaliação pré-operatória do pneumopata

Ramos

Filho²,

Pereira³

et al. 2003

Rev. Bras. Anestesiol.

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Justificativa e Objetivos -As complicações pulmonares são a s c a u s a s m a i s f r e q ü e n t e s d e m o r b i m o r t a l i d a d e pós-operatória C o n c l u s õ e s -O p o r t a d o r d e d o e n ç a r e s p i r a t ó r i a , especialmente as de evolução crônica, necessita ser rigorosamente avaliado no pré-operatório. A classificação do estado físico (ASA) e o índice de Goldman são fatores de p r e v i s ã o d e r i s c o i m p o r t a n t e s n o s p n e u m o p a t a s não-candidatos à ressecção pulmonar. Somando-se a esses critérios, nos candidatos à ressecção pulmonar, o VO 2 max, o V E F 1 e c a p a c i d a d e d e d i f u s ã o e s t i m a d o s p a r a

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“…However, the preoperative assessment of risk for postoperative pulmonary complications in the general population has recently been reviewed (601,602). Except for issues pertaining to the increased risk of opportunistic pulmonary infections, the preoperative evaluation of renal transplant candidates should be similar to that for patients facing other types of surgery (603)(604)(605)(606)(607)(608)(609)(610)(611)(612). The highest risk of respiratory complications is in patients undergoing thoracic or upper abdominal operations (603)(604)(605)(606)608), and the risk might be expected to be lower in the patient having a kidney transplant.…”

Section: Pulmonarymentioning

confidence: 99%

“…Except for issues pertaining to the increased risk of opportunistic pulmonary infections, the preoperative evaluation of renal transplant candidates should be similar to that for patients facing other types of surgery (603)(604)(605)(606)(607)(608)(609)(610)(611)(612). The highest risk of respiratory complications is in patients undergoing thoracic or upper abdominal operations (603)(604)(605)(606)608), and the risk might be expected to be lower in the patient having a kidney transplant. By multivariate analysis, risk factors for postoperative pulmonary complications that developed in 11.8% of adult, male recipients undergoing elective abdominal surgery, were postoperative nasogastric suction, preoperative sputum production and longer duration of anesthesia (613).…”

Section: Pulmonarymentioning

confidence: 99%

“…However, obesity, at least among women, was found to be an independent risk factor for hospital length of stay and cost following renal transplantation (615). Some have suggested that the forced expiratory volume is the best predictor of postoperative respiratory complications (604), and this test may be useful for selected patients with known pulmonary disease. The ''prohibitive'' risk group can successfully undergo surgery with careful preparation (603,608,609).…”

Section: Pulmonarymentioning

confidence: 99%

See 1 more Smart Citation

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

2001

American Journal of Transplantation

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Preoperative Pulmonary Preparation of Patients with Chronic Obstructive Pulmonary Disease

Cited by 175 publications

References 9 publications

Anesthetic Considerations in Candidates for Lung Volume Reduction Surgery

Anesthetic Considerations in Candidates for Lung Volume Reduction Surgery

Avaliação pré-operatória do pneumopata

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

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