Preoperative Pulmonary Update

Smetana, Gerald W.; Conde, Michelle V.

doi:10.1016/j.cger.2008.06.004

Cited by 23 publications

(35 citation statements)

References 66 publications

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“…Increasing age is an independent risk factor for postoperative pulmonary complications secondary to age-related reduction in pulmonary compliance, reduced responsiveness to hypoxia and hypercapnia, and diminished oropharyngeal protective reflexes. [50][51][52][53] The reason for the high rate of bleeding necessitating blood transfusion may be lower hemoglobin concentration at admission in this age group because anemia is more prevalent in elderly patients. 54 Advanced age is not associated with major alterations in the coagulation cascade, and consequently age alone does not increase the risk of bleeding.…”

Section: Original Research and Contributionsmentioning

confidence: 99%

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Irojah¹,

Bell

Grim

et al. 2017

TPJ

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Context: Cholecystectomy is the most common general surgery procedure in patients older than age 65 years. By 2050, it is estimated that 2.0% of the population will be older than age 90 years.Objective: To assess the mortality of cholecystectomy in superelderly patients (≥ age 90 years).Design were open and 791 (78.6%) were laparoscopic. Mortality did not decrease significantly during the study period. The overall mortality was 5.5%, significantly less for the laparoscopic group (3.7% vs 12%, p < 0.001) and for the nonemergent group (4.5% vs 9.5%, p < 0.005). The median length of stay for open cholecystectomy was 9 days compared with 5 days for laparoscopic (p < 0.001); for nonemergent cholecystectomy it was 5 days compared with 7 days for emergent cholecystectomy (p < 0.001).Conclusion: The mortality after cholecystectomy in superelderly patients did not change significantly during the study period. The mortality and morbidity for laparoscopic and elective procedures were significantly lower than for open procedures and for emergent procedures, respectively.

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Section: Original Research and Contributionsmentioning

confidence: 99%

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Irojah¹,

Bell

Grim

et al. 2017

TPJ

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“…The following are considered POPC: pneumonia, tracheobronchial infection, atelectasis with clinical repercussions, bronchospasm, acute respiratory failure, prolonged tracheal intubation or mechanical ventilation (more than 48 hours). Several authors also consider fever with no definite cause, pulmonary embolism, pleural hemorrhage and bronchopleural fistula to belong to this group [3][4][5][6][7][8] . There are links between POPC and preoperative risk factors.…”

Section: Introductionmentioning

confidence: 99%

Valor dos achados clínicos e da avaliação funcional pulmonar pré-operatórios como preditores das complicações pulmonares pós-operatórias

Silva¹,

Gazzana²,

Knorst³

2010

Rev. Assoc. Med. Bras.

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objectIve. To assess the relationship of clinical data and the results of preoperative pulmonary functional evaluation with postoperative pulmonary complications. Methods. We conducted a retrospective cohort study with patients who underwent pulmonary functional evaluation over a period of 5 years. We analyzed clinical, demographic and spirometric data, surgical procedures performed and postoperative pulmonary complications. results. We analyzed the medical records of 521 patients. Mean age was 59.5 ± 14 years, 65.8% were male, and 93.4% were white. Mean FEV1 was 76.6 ± 24.6% of predicted. There were clinical comorbidities in 73.5% of all cases (COPD in 29.8%). The most common surgical sites were thorax (n = 122; 23.4%) and upper abdomen (n = 117; 22.5%). Postoperative pulmonary complications occurred in 99 patients (19.0%), with respiratory failure being the most common (4.6%). Forty-three (8.3%) patients died. Rates of pulmonary complications were higher after thoracic (28.9%), cardiac (28%) and upper abdomen surgery (24.3%) (p≤0.0001). Most patients (66.7%) with pulmonary complications were classified as ASA III or IV (p<0.01), and in 70.2% of operations, time on anesthesia was > 3.5 hours (p≤0.0001). The difference in median length of hospital stay between patients with and without pulmonary complications was statistically significant (23.5 [15.8-34] days vs. 10 [6-18] days; p<0.001). Patients who had never smoked had fewer complications than those with current or past smoking history (p=0.04). We did not detect significant associations between postoperative pulmonary complications and presence of COPD, FEV1 or body mass index (p>0.05). conclusIon. The most important factors associated with postoperative pulmonary complications were surgical site, time of anesthesia, and ASA classification.

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“…[19]If time permits, the patient should be advised to stop smoking for 2 months prior to elective surgery. [20] …”

Section: Preoperative Evaluationmentioning

confidence: 99%

Perioperative Anaesthetic Management in Asthma

Shaikh

Nilangekar²

2015

Int Jour of Biomed Res

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Asthma is a chronic disorder of airway characterized by hypersensitiveness to a variety of triggers. With a potential to cause an anaesthetic disaster during perioperative period, acute episode of asthma can lead to life threatening complications. It is important for an anaesthesiologist to make a positive difference in the outcome of the asthmatic patient by stepwise approach pre, peri and post operatively.This review takes the anaesthetist's perspective to discuss the approach to asthma, safe practices and special considerations to be followed in asthmatics. This article focuses on the pathophysiology, pharmacotherapy and perioperative management in acute bronchial asthma.

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Preoperative Pulmonary Update

Cited by 23 publications

References 66 publications

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Are They Too Old for Surgery? Safety of Cholecystectomy in Superelderly Patients (≥ Age 90)

Valor dos achados clínicos e da avaliação funcional pulmonar pré-operatórios como preditores das complicações pulmonares pós-operatórias

Perioperative Anaesthetic Management in Asthma

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