Recent advances in understanding and managing postoperative respiratory problems
Postoperative respiratory complications increase healthcare utilization (e.g. hospital length of stay, unplanned admission to intensive care or high-dependency units, and hospital readmission), mortality, and adverse discharge to a nursing home. Furthermore, they are associated with significant cost...
| Main Authors: | , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
F1000 Research Ltd
2019
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| _version_ | 1826289915515633664 |
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| author | Eikermann, M Santer, P Ramachandran, S Pandit, J |
| author_facet | Eikermann, M Santer, P Ramachandran, S Pandit, J |
| author_sort | Eikermann, M |
| collection | OXFORD |
| description | Postoperative respiratory complications increase healthcare utilization (e.g. hospital length of stay, unplanned admission to intensive care or high-dependency units, and hospital readmission), mortality, and adverse discharge to a nursing home. Furthermore, they are associated with significant costs. Center-specific treatment guidelines may reduce risks and can be guided by a local champion with multidisciplinary involvement. Patients should be risk-stratified before surgery and offered anesthetic choices (such as regional anesthesia). It is established that laparoscopic surgery improves respiratory outcomes over open surgery but requires tailored anesthesia/ventilation strategies (positive end-expiratory pressure utilization and low inflation pressure). Interventions to optimize treatment include judicious use of intensive care, moderately restrictive fluid therapy, and appropriate neuromuscular blockade with adequate reversal. Patients' ventilatory drive should be kept within a normal range wherever possible. High-dose opioids should be avoided, while volatile anesthetics appear to be lung protective. Tracheal extubation should occur in the reverse Trendelenburg position, and postoperative continuous positive airway pressure helps prevent airway collapse. In combination, all of these interventions facilitate early mobilization. |
| first_indexed | 2024-03-07T02:36:11Z |
| format | Journal article |
| id | oxford-uuid:a8dfd161-6fc3-4ca0-8333-7c3550742b37 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:36:11Z |
| publishDate | 2019 |
| publisher | F1000 Research Ltd |
| record_format | dspace |
| spelling | oxford-uuid:a8dfd161-6fc3-4ca0-8333-7c3550742b372022-03-27T03:04:32ZRecent advances in understanding and managing postoperative respiratory problemsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a8dfd161-6fc3-4ca0-8333-7c3550742b37EnglishSymplectic Elements at OxfordF1000 Research Ltd2019Eikermann, MSanter, PRamachandran, SPandit, JPostoperative respiratory complications increase healthcare utilization (e.g. hospital length of stay, unplanned admission to intensive care or high-dependency units, and hospital readmission), mortality, and adverse discharge to a nursing home. Furthermore, they are associated with significant costs. Center-specific treatment guidelines may reduce risks and can be guided by a local champion with multidisciplinary involvement. Patients should be risk-stratified before surgery and offered anesthetic choices (such as regional anesthesia). It is established that laparoscopic surgery improves respiratory outcomes over open surgery but requires tailored anesthesia/ventilation strategies (positive end-expiratory pressure utilization and low inflation pressure). Interventions to optimize treatment include judicious use of intensive care, moderately restrictive fluid therapy, and appropriate neuromuscular blockade with adequate reversal. Patients' ventilatory drive should be kept within a normal range wherever possible. High-dose opioids should be avoided, while volatile anesthetics appear to be lung protective. Tracheal extubation should occur in the reverse Trendelenburg position, and postoperative continuous positive airway pressure helps prevent airway collapse. In combination, all of these interventions facilitate early mobilization. |
| spellingShingle | Eikermann, M Santer, P Ramachandran, S Pandit, J Recent advances in understanding and managing postoperative respiratory problems |
| title | Recent advances in understanding and managing postoperative respiratory problems |
| title_full | Recent advances in understanding and managing postoperative respiratory problems |
| title_fullStr | Recent advances in understanding and managing postoperative respiratory problems |
| title_full_unstemmed | Recent advances in understanding and managing postoperative respiratory problems |
| title_short | Recent advances in understanding and managing postoperative respiratory problems |
| title_sort | recent advances in understanding and managing postoperative respiratory problems |
| work_keys_str_mv | AT eikermannm recentadvancesinunderstandingandmanagingpostoperativerespiratoryproblems AT santerp recentadvancesinunderstandingandmanagingpostoperativerespiratoryproblems AT ramachandrans recentadvancesinunderstandingandmanagingpostoperativerespiratoryproblems AT panditj recentadvancesinunderstandingandmanagingpostoperativerespiratoryproblems |