scholarly journals Spirometric lung age for predicting the risk of pulmonary complications after thoracic surgeries

2021 ◽  
Vol 25 (4) ◽  
pp. 563-566
Author(s):  
O. Yu. Usenko ◽  
A. V. Sydiuk ◽  
O. E. Sydiuk ◽  
A. S. Klimas ◽  
G. Yu. Savenko ◽  
...  
Keyword(s):  
Strong Association ◽  
Pulmonary Complications ◽  
Postoperative Pneumonia ◽  
Thoracic Cavity ◽  
Postoperative Pulmonary Complications ◽  
Optimal Point ◽  
Term Survival ◽  
Statistical Software ◽  
Respiratory Dysfunction ◽  
Lung Age

Annotation. Surgical interventions for diseases of the thoracic cavity are one of the most invasive surgical procedures, which are often accompanied by postoperative complications, which increase mortality, prolong hospital stays, require additional costs and correlate with poor long-term survival. However, respiratory complications remain the most common of non-surgical complications and their frequency varies from 13 to 38%. So far, several studies have shown that respiratory dysfunction is an independent risk factor for postoperative pneumonia. The aim – investigate whether it is possible to use spirometric lung age to predict the occurrence of postoperative pneumonia after thoracic surgeries. The study was performed on 192 patients with diseases of the thoracic cavity (esophagus, lungs, mediastinum), underwent surgery in the thoracoabdominal department of the Shalimov’s National Institute of Surgery and Transplantation. Statistical software EZR v.1.54 was used for statistical calculations (graphical user interface for statistical software R version 4.0.3, R Foundation for Statistical Computing, Vienna, Austria). We found a very strong association between the risk of developing pulmonary complications and the age of the lungs, AUC=0.97 (95% confidence interval from 0.94 to 0.99). When choosing the optimal point for predicting the risk of pulmonary complications obtained: Lung age critical = 99.6 years. Thus, at Lung age >99.6 years, the development of postoperative pulmonary complications is predicted. At Lung age <99.6 years, the absence of postoperative pulmonary complications is predicted. When choosing this decision point, the sensitivity is 93.5% (82.1-98.6%), specificity – 95.9% (91.3-98.5%). Therefore, spirometric age of the lungs was associated with the incidence of postoperative pulmonary complications in patients undergoing surgery for thoracic disease. This parameter deserves attention as a predictor of the probability of developing postoperative pneumonia after thoracic surgeries and can help in assessing the state of respiratory function of patients.

scholarly journals Algorithm for the prevention of pulmonary complications after thoracic surgeries

2021 ◽  
Vol 25 (3) ◽  
pp. 462-465
Author(s):  
O. Yu. Usenko ◽  
A. V. Sydiuk ◽  
O. E. Sydiuk ◽  
A. S. Klimas ◽  
G. Yu. Savenko ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Pulmonary Complications ◽  
Control Group ◽  
Study Group ◽  
Thoracic Cavity ◽  
Term Survival ◽  
Statistical Software ◽  
Results Of Treatment ◽  
Retrospective Comparison ◽  
The Difference

Annotation. The biggest problem after operations on the thoracic cavity is the number of pulmonary complications (according to various authors 26-38% of cases). Despite the development of numerous methods for the prevention and treatment of these complications, they remain one of the leading causes of hospital mortality and may be an independent risk factor for worse long-term survival. Therefore, the aim of the work was to improve the results of treatment of patients after operations on the thoracic cavity by developing an algorithm for anesthesia for perioperative prevention of pulmonary complications. Participated in the study 192 patients with diseases of the thoracic cavity (esophagus, lungs, mediastinum), operated on in the thoracoabdominal department of the National Institute of Surgery and Transplantology named after O.O. Shalimov. Retrospective comparison group - 96 patients after thoracic surgery, which used conventional methods of perioperative management. The study group consisted of 96 patients after thoracic surgery, who used a perioperative anesthesia algorithm for the prevention of pulmonary complications. Statistical software EZR v. Was used for statistical calculations. 1.54 (graphical user interface for statistical software R version 4.0.3, R Foundation for Statistical Computing, Vienna, Austria). When conducting a multifactor analysis, it was found that the proposed method of prevention of pulmonary complications can reduce (p=0.001) the risk of development, HS=0.27 (95% CI 0.13-0.58) compared with the control group (with standardization by sex, weight, ASA of the patient). Pulmonary complications developed in 33 (34.4%) patients of the control group and in 13 (13.5%) patients of the study group, the difference was statistically significant, p=0.001. Thus, the application of the proposed technique reduces (p = 0.001) the risk of complications, BP=0.39 (95% CI 0.22 - 0.70) compared to traditional methods.

E. Ulrich. On the issue of prevention and treatment of postoperative pneumonia with quinine-calcium. (Zbl. F. Ghir., 1936, 38, 2244-2247)

1937 ◽  
Vol 33 (7) ◽  
pp. 939-939
Author(s):  
B. Ivanov
Keyword(s):  
Postoperative Complications ◽  
Pulmonary Complications ◽  
Gluteal Region ◽  
Postoperative Pneumonia ◽  
Postoperative Pulmonary Complications ◽  
Prophylactic Administration ◽  
Prevention And Treatment

Based on his observations, a. indicates that as a result of the prophylactic administration of quinine-calcium on the day of surgery and on the next two days, the frequency of postoperative pulmonary complications is reduced by about three times, and the developing complications are relatively easy (in 2/3 cases, it was only about simple bronchitis); in cases where the prophylactic administration of quinine-calcium was not produced, the vast majority of postoperative complications were pneumonia and bronchopneumonia. A. also reports on the good results of the use of quinine-calcium as a remedy for bronchitis, pneumonia and bronchopneumonia. Using Sandoz quinine calcium, as well. for prophylactic purposes, it injects it into the muscles of the gluteal region in an amount of 10 cm3 on the day of surgery, 2 times 10 cm3 the next day and another 10 cm3 on the second day after surgery.

scholarly journals Effect of sugammadex on postoperative pulmonary complications in patients with respiratory dysfunction after laparoscopic gastric or intestinal surgery: A retrospective study

2020 ◽  
Author(s):  
Yiqin Ji ◽  
Hui Yuan ◽  
Yijun Chen ◽  
Xincai Zhang ◽  
Fan Wu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pleural Effusion ◽  
Binary Logistic Regression ◽  
Pulmonary Complications ◽  
Regression Analyses ◽  
Postoperative Pulmonary Complications ◽  
Intestinal Surgery ◽  
Respiratory Dysfunction ◽  
Postoperative Fever ◽  
The Relationship

Abstract Background Use of sugammadex is associated with fewer postoperative pulmonary complications. This study investigated the relationship between sugammadex and postoperative pulmonary complications (PPC) in specific patients with respiratory dysfunction. Methods The authors reviewed the electronic medical and anesthesia records of patients with respiratory dysfunction who had laparoscopic gastric or intestinal surgery at a single center between May 01, 2018, and December 31, 2019. The patients were divided into the sugammadex group and the non-sugammadex group, based on whether or not they received sugammadex. Binary logistic regression analyses were used to characterize the differences in incidence of PPC. Results A total of 112 patients were included, of which 46 patients (41.07%) received sugammadex. In the logistic regression analysis, the incidences of PPC were fewer in the sugammadex group. Postoperative fever [Odds Ratio (OR) 0.330; 95% Confidence Interval (CI) 0.137–0.793, p = 0.0213], postoperative ICU admission (OR 0.204; 95% CI 0.065 to 0.644, p = 0.007), cough (OR 0.143; 95% CI 0.061 to 0.333, p < 0.001), pleural effusion (all) (OR: 0.280; 95% CI 0.104 to 0.759, p = 0.012), pleural effusion (massive) (OR: 0.142; 95% CI 0.031 to 0.653, p = 0.012), and difficulty in breathing (OR: 0.111; 95% CI 0.014 to 0.849, p = 0.039) showed significant differences between the two groups. Conclusions Sugammadex-mediated reversal of neuromuscular blockade can reduce the PPC in patients with respiratory dysfunction.

scholarly journals The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a posthoc propensity score–weighted cohort analysis of the LAS VEGAS study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guido Mazzinari ◽  
◽  
Ary Serpa Neto ◽  
Sabrine N. T. Hemmes ◽  
Goran Hedenstierna ◽  
...  
Keyword(s):  
Propensity Score ◽  
Adverse Events ◽  
Abdominal Surgery ◽  
Las Vegas ◽  
Cohort Analysis ◽  
Risk Difference ◽  
Pulmonary Complications ◽  
Driving Pressure ◽  
Postoperative Pulmonary Complications ◽  
Open Abdominal Surgery

Abstract Background It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time–weighted average ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW with intraoperative adverse events. Methods Posthoc retrospective propensity score–weighted cohort analysis of patients undergoing open or closed abdominal surgery in the ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries. The primary endpoint was a composite of PPCs. The secondary endpoint was a composite of intraoperative adverse events. Results The analysis included 1128 and 906 patients undergoing open or closed abdominal surgery, respectively. The PPC rate was 5%. ΔP was lower in open abdominal surgery patients, but ΔPTW was not different between groups. The association of ΔPTW with PPCs was significant in both groups and had a higher risk ratio in closed compared to open abdominal surgery patients (1.11 [95%CI 1.10 to 1.20], P <  0.001 versus 1.05 [95%CI 1.05 to 1.05], P <  0.001; risk difference 0.05 [95%CI 0.04 to 0.06], P <  0.001). The association of ΔPTW with intraoperative adverse events was also significant in both groups but had higher odds ratio in closed compared to open abdominal surgery patients (1.13 [95%CI 1.12– to 1.14], P <  0.001 versus 1.07 [95%CI 1.05 to 1.10], P <  0.001; risk difference 0.05 [95%CI 0.030.07], P <  0.001). Conclusions ΔP is associated with PPC and intraoperative adverse events in abdominal surgery, both in open and closed abdominal surgery. Trial registration LAS VEGAS was registered at clinicaltrials.gov (trial identifier NCT01601223).

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