Risk of respiratory failure after repair of thoracoabdominal aortic aneurysms

Money, Samuel R.; Rice, Karen L.; Crockett, Donald; Becker, Mark O.; Abdoh, Ahmed A.; Wisselink, Willem; Kazmier, Francis J.; Hollier, Larry H.

doi:10.1016/s0002-9610(94)80057-x

Cited by 80 publications

(43 citation statements)

References 12 publications

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“…Svensson et al (30) found a 60% overall incidence of respiratory complications in the postoperative period following corrective surgery for thoracoabdominal aneurysm (atelectasis in 37%, pleural effusion in 21%, pneumonia in 9%, pneumothorax in 8%, and acute respiratory distress syndrome in 3%). Money et al (11) found a 68% incidence of pneumonia in patients subjected to prolonged MV in the postoperative period following surgery for a thoracoabdominal aortic aneurysm. Furthermore, Ingersoll and Grippi (1) reported a higher incidence of pulmonary atelectasis in cardiac surgery patients who underwent late extubation with more than 24 h of MV.…”

Section: Discussionmentioning

confidence: 99%

“…The time interval for defining prolonged MV or extubation failure has yet to be established, ranging from 6 to 48 h in recent studies (6)(7)(8)(9) and from 2 to 7 days in older studies (10,11). The maintenance of patients on MV for a prolonged length of time can cause complications such as development of oxygen toxicity, larynx injuries, tracheal stenosis, selective intubation, sinusitis, barotrauma, reduced cardiac output, pneumonia, and psychological problems (12).…”

Section: Introductionmentioning

confidence: 99%

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Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Vidotto

Sogame

Gazzotti

et al. 2011

Braz J Med Biol Res

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48 h) until discharge from the hospital or death. The occurrence of PPC, incidence of death, the need for reoperation and tracheostomy, and the length of hospitalization were assessed during the postoperative period. Twenty-six patients (8.2%) experienced extubation failure and 30 (9.5%) needed prolonged MV after surgery. Multivariate analysis showed that extubation failure was significant for the occurrence of death (OR = 8.05 [1.88; 34.36]), PPC (OR = 11.18 [2.27; 55.02]) and tracheostomy (OR = 7.8 [1.12; 55.07]). Prolonged MV was significant only for the occurrence of PPC (OR = 4.87 [1.3; 18.18]). Elective intracranial surgery patients who experienced extubation failure or required prolonged MV had a higher incidence of PPC, reoperation and tracheostomy and required a longer period of time in the ICU. Level of consciousness and extubation failure were associated with death and PPC. Patients who required prolonged MV had a higher incidence of extubation failure.]]>

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Vidotto

Sogame

Gazzotti

et al. 2011

Braz J Med Biol Res

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“…79,80,89 The risk of postoperative complications also depends on the type of surgery. The rate of complication is higher in patients undergoing abdominal surgery [90][91][92] and is also increased with aortic aneurysm repair, [93][94][95][96] vascular, 74,78,79,93 thoracic, 83,90,93,96 and neck surgery. 83,96,97 Gupta et al have shown an increased risk of postoperative complications (39% vs 18%), higher rate of transfer to ICU (24% vs 9%), and increased length of hospital stay in patients with obstructive sleep apnea compared with control subjects matched for age, sex, and body mass index (BMI).…”

Section: Evidence On Sleep Apnea As a Risk Factor For Perioperative Cmentioning

confidence: 99%

Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

Vasu

Grewal

Doghramji

2012

Journal of Clinical Sleep Medicine

217

147

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Obstructive sleep apnea syndrome (OSAS) is a common sleep related breathing disorder. Its prevalence is estimated to be between 2% and 25% in the general population. However, the prevalence of sleep apnea is much higher in patients undergoing elective surgery. Sedation and anesthesia have been shown to increase the upper airway collapsibility and therefore increasing the risk of having postoperative complications in these patients. Furthermore, the majority of patients with sleep apnea are undiagnosed and therefore are at risk during the perioperative period. It is important to identify these patients so that appropriate actions can be taken in a timely fashion. In this review article, we will discuss the epidemiology of sleep apnea in the surgical population. We will also discuss why these patients are at a higher risk of having postoperative complications, with the special emphasis on the role of anesthesia, opioids, sedation, and the phenomenon of REM sleep rebound. We will also review how to identify these patients preoperatively and the steps that can be taken for their perioperative management. OSAS has been shown to be associated with various healthrelated consequences, including increased rate of motor vehicle accidents, hypertension, diabetes mellitus, congestive heart failure, stroke, and all-cause mortality. [1][2][3][4][5][6][7][8][9] Recently, numerous studies have demonstrated that surgical patients with sleep apnea are at increased risk of having perioperative complications, including hypoxemia, pneumonia, diffi cult intubation, myocardial infarction, pulmonary embolism, atelectasis, cardiac arrhythmias, and unanticipated admission to the ICU. The majority of patients with OSA are undiagnosed upon admission and are at risk during the perioperative period, presumably due to their underlying sleep apnea. Therefore, it is very important to identify these patients preoperatively so that one can initiate appropriate perioperative measures. EpidemiologyOSAS is an extremely common sleep related breathing disorder, and its prevalence has been increasing throughout the world because of obesity and increasing age of the general population. Its prevalence is between 2% and 25% in the general population, depending upon how sleep apnea is defi ned. In an epidemiological study, Young et al. noted that the prevalence of sleep apnea, defi ned as apnea-hypopnea index (AHI) ≥ 5/h was 9% for women and 24% for men. 10 However, the prevalence of OSAS (defi ned as AHI ≥ 5/h and daytime sleepiness) was 2% in women and 4% in men. 10 The National Sleep Foundation (NSF) Sleep in America 2005Poll found that 1 in 4 Americans are at high risk of having sleep apnea based on the Berlin Questionnaire. 11 The prevalence of sleep apnea is much higher in surgical patients and depends on the type of surgery. In the bariatric surgery population, the prevalence of sleep apnea has been found to be > 70%. 12,13 It is the standard of care for these patients to get a formal sleep evaluation prior to undergoing the bariatric surgery. Howev...

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“…33 Surgical patients receiving allogeneic transfusions develop impaired cellular immunity [34][35][36][37][38] associated with increases in postoperative bacterial infections, [39][40][41][42] cancer recurrence, 43,44 multiorgan failure, [45][46][47][48][49][50] and poorer wound healing. [51][52][53] Could ABO nonidentical transfusions cause impaired cellular immune function, infection, and multiorgan failure, but by a different mechanism than that causing hemolysis?…”

Section: Transfusion Studiesmentioning

confidence: 99%

What would Karl Landsteiner do? The ABO blood group and stem cell transplantation

Heal

Liesveld

Phillips

et al. 2005

Bone Marrow Transplant

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Summary:ABO blood group antigens, of great importance in transplantation and transfusion, are present on virtually all cells, as well as in soluble form in plasma and body fluids. Naturally occurring plasma IgM and IgG antibodies against these antigens are ubiquitous. Nonetheless, the ABO blood group system is widely ignored by many transfusion services, except for purposes of red cell transfusion. We implemented a policy of transfusing only ABO identical platelets and red cells in patients undergoing stem cell transplantation or treatment for hematologic malignancies. Major bleeding episodes have occurred in about 5% of patients undergoing induction therapy for acute leukemia as compared with 15-20% in the literature. Overall survival times appear to be superior to that in historical cohorts. In 2002-2004, treatment-related mortality at 100 days in our Blood and Marrow Transplant Unit was 0.7% for autologous transplants (n ¼ 148), 13% for sibling allogeneic transplants (n ¼ 110), and 24% (n ¼ 62) for matched unrelated allogeneic transplants, suggesting that our approach is safe. We speculate that more rigorous efforts on the part of transfusion services to provide ABO identical blood components, and to remove incompatible supernatant plasma, when necessary, might yield reduced morbidity and mortality in patients undergoing stem cell transplantation. Bone Marrow Transplantation (2005) 36, 747-755.

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Risk of respiratory failure after repair of thoracoabdominal aortic aneurysms

Cited by 80 publications

References 12 publications

Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Implications of extubation failure and prolonged mechanical ventilation in the postoperative period following elective intracranial surgery

Obstructive Sleep Apnea Syndrome and Perioperative Complications: A Systematic Review of the Literature

What would Karl Landsteiner do? The ABO blood group and stem cell transplantation

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