Relevant bibliographies by topics / Postoperative respiratory complications

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  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers

Academic literature on the topic 'Postoperative respiratory complications'

Author: Grafiati
Published: 4 June 2021
Last updated: 8 February 2022

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Journal articles on the topic "Postoperative respiratory complications"

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Domi, Rudin. "Postoperative Respiratory Complications." International Journal of Anesthetics and Anesthesiology 1, no. 1 (July 10, 2014): 1–2. http://dx.doi.org/10.23937/2377-4630/1002.

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McPherson, Kirstie, and Robert Stephens. "Postoperative respiratory complications." British Journal of Hospital Medicine 77, no. 4 (April 2, 2016): C60—C64. http://dx.doi.org/10.12968/hmed.2016.77.4.c60.

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Staehr-Rye, Anne K., and Matthias Eikermann. "Eliminate postoperative respiratory complications." European Journal of Anaesthesiology 32, no. 7 (July 2015): 455–57. http://dx.doi.org/10.1097/eja.0000000000000210.

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Platis, Cari Maria, Ludmyla Kachko, Evelyna Trabikin, Eliahu Simhi, Meshulam Bahar, and Jacob Katz. "Postoperative respiratory complications in Joubert syndrome." Pediatric Anesthesia 16, no. 7 (July 2006): 799–800. http://dx.doi.org/10.1111/j.1460-9592.2006.01864.x.

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Al-Rawi, Samar, and Kathy Nolan. "Respiratory Complications in the Postoperative Period." Anaesthesia & Intensive Care Medicine 4, no. 10 (October 2003): 332–34. http://dx.doi.org/10.1383/anes.4.10.332.27314.

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C. B., Praveen, and Imran Thariq Ajmal. "Clinical study of respiratory complications in patients undergoing elective upper abdominal surgery." International Surgery Journal 6, no. 3 (February 25, 2019): 732. http://dx.doi.org/10.18203/2349-2902.isj20190515.

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Background: Postoperative pulmonary complication is a major cause of morbidity, mortality, prolonged hospital stay and increased cost of care especially when it involves Upper Abdominal surgery. The predictable changes in lung function include a decrease in vital capacity and functional residual capacity, which are more striking in obese patients and in the supine. Aim is to study the incidence of respiratory complications in patients undergoing elective upper abdominal surgery with identification of risk factors namely Age, Sex, Obesity, Smoking and duration of upper abdominal Surgery for the development of Respiratory complications using a Peak Flow Meter as a bedside predictive test.Methods: Peak expiratory flow rate (PEFR) measurement daily up to 7 days post-surgery, were noted to monitor the occurrence of postoperative respiratory complications.Results: The study results according to our study showed that14 (34.1%) male patients out of 41 had postoperative complications as compared to 15 (48.3%) out of 31 female patients. 30.5% patients were obese and had postoperative complications of 9.75%. Overall 40% of smokers had postoperative complications. Postoperatively sub costal incision had complications (41%) in 36 patients, roof top incisions 4 out of 5 (80%) and para-umbilical incisions 3 out of 4 (75%). 80% of the patients who had upper abdominal transverse incisions developed microatelectasis followed by 75% of patients who had par median incisions.Conclusions: Respiratory complications following elective upper abdominal surgery are influenced by Increasing age and obesity and Smoking affected post-operative pulmonary recovery. Type of incision could also help change the incidence of complications.
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Ali, Zulfiqar. "Early postoperative respiratory complications following elective craniotomies." Journal of Neuroanaesthesiology and Critical Care 02, no. 02 (August 2015): 85–87. http://dx.doi.org/10.4103/2348-0548.155455.

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ANDERSON, P. R., M. R. PUNO, S. L. LOVELL, and C. R. SWAYZE. "Postoperative Respiratory Complications in Non-Idiopathic Scoliosis." Acta Anaesthesiologica Scandinavica 29, no. 2 (February 1985): 186–92. http://dx.doi.org/10.1111/j.1399-6576.1985.tb02183.x.

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Bai, Johnny W., Mandeep Singh, Anthony Short, Didem Bozak, Frances Chung, Vincent W. S. Chan, Anuj Bhatia, and Anahi Perlas. "Intrathecal Morphine and Pulmonary Complications after Arthroplasty in Patients with Obstructive Sleep Apnea." Anesthesiology 132, no. 4 (April 1, 2020): 702–12. http://dx.doi.org/10.1097/aln.0000000000003110.

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Abstract Background Intrathecal morphine is commonly and effectively used for analgesia after joint arthroplasty, but has been associated with delayed respiratory depression. Patients with obstructive sleep apnea may be at higher risk of postoperative pulmonary complications. However, data is limited regarding the safety of intrathecal morphine in this population undergoing arthroplasty. Methods This retrospective cohort study aimed to determine the safety of intrathecal morphine in 1,326 patients with documented or suspected obstructive sleep apnea undergoing hip or knee arthroplasty. Chart review was performed to determine clinical characteristics, perioperative events, and postoperative outcomes. All patients received neuraxial anesthesia with low-dose (100 μg) intrathecal morphine (exposure) or without opioids (control). The primary outcome was any postoperative pulmonary complication including: (1) respiratory depression requiring naloxone; (2) pneumonia; (3) acute respiratory event requiring consultation with the critical care response team; (4) respiratory failure requiring intubation/mechanical ventilation; (5) unplanned admission to the intensive care unit for respiratory support; and (6) death from a respiratory cause. The authors hypothesized that intrathecal morphine would be associated with increased postoperative complications. Results In 1,326 patients, 1,042 (78.6%) received intrathecal morphine. The mean age of patients was 65 ± 9 yr and body mass index was 34.7 ± 7.0 kg/m2. Of 1,326 patients, 622 (46.9%) had suspected obstructive sleep apnea (Snoring, Tired, Observed, Pressure, Body Mass Index, Age, Neck size, Gender [STOP-Bang] score greater than 3), while 704 of 1,326 (53.1%) had documented polysomnographic diagnosis. Postoperatively, 20 of 1,322 (1.5%) patients experienced pulmonary complications, including 14 of 1,039 (1.3%) in the exposed and 6 of 283 (2.1%) in the control group (P = 0.345). Overall, there were 6 of 1 322 (0.5%) cases of respiratory depression, 18 of 1,322 (1.4%) respiratory events requiring critical care team consultation, and 4 of 1,322 (0.3%) unplanned intensive care unit admissions; these rates were similar between both groups. After adjustment for confounding, intrathecal morphine was not significantly associated with postoperative pulmonary complication (adjusted odds ratio, 0.60 [95% CI, 0.24 to 1.67]; P = 0.308). Conclusions Low-dose intrathecal morphine, in conjunction with multimodal analgesia, was not reliably associated with postoperative pulmonary complications in patients with obstructive sleep apnea undergoing joint arthroplasty. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New
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Bahr, Katherine L., Lisa Howe, Carl Jessen, and Zachary Goodrich. "Outcome of 45 Dogs With Laryngeal Paralysis Treated by Unilateral Arytenoid Lateralization or Bilateral Ventriculocordectomy." Journal of the American Animal Hospital Association 50, no. 4 (July 1, 2014): 264–72. http://dx.doi.org/10.5326/jaaha-ms-6081.

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The purpose of this retrospective study was to assess risk factors and complications affecting postoperative outcome of dogs with laryngeal paralysis treated by either unilateral arytenoid lateralization (UAL) or bilateral ventriculocordectomy (VCC). Medical records of all dogs having either UAL or VCC between 2000 and 2011 were analyzed. Twenty-five dogs had VCC and 20 dogs had UAL. The overall postoperative complications rates for VCC and UAL were similar (52% and 60%, respectively; P = .0887). Dogs that had UAL were more likely to have acute postoperative respiratory distress and aspiration pneumonia (P = .0526). Dogs with VCC were more likely to have chronic postoperative respiratory distress and aspiration pneumonia (P = .0079). Revision surgery was required in 6 dogs (24%) following VCC and 2 dogs (10%) following UAL. Sex, breed, presenting complaint, type of service provided, and concurrent diseases were not significantly associated with higher risk of either death or decreased survival time postoperatively with either procedure. Overall postoperative complication rates, required revision surgeries, and episodes of aspiration pneumonia were similar in dogs undergoing UAL and VCC surgeries. Dogs that had VCC appeared to have an increased risk of lifelong complications postoperatively compared with UAL; therefore, VCC may not be the optimal choice for treatment of laryngeal paralysis.
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Dissertations / Theses on the topic "Postoperative respiratory complications"

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Svärd, Elin, and Anna-Karin Vilhelmsson. "Intensivvårdssjuksköterskans omvårdnadsåtgärder för att förebygga luftvägskomplikationer hos den postoperativa patienten." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-26655.

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Bakgrund: Postoperativa luftvägskomplikationer är vanligt förekommande och ökar risken för både morbiditet och mortalitet samt ökar kostnaderna för samhället. Olika omvårdnadsåtgärder finns för att förebygga postoperativa luftvägskomplikationer. Syfte: Syftet med studien var att beskriva hur intensivvårdssjuksköterskor definierar begreppet postoperativa luftvägskomplikationer, samt deras omvårdnadsåtgärder för att förebygga dessa komplikationer hos den postoperativa patienten Metod: Studien genomfördes med en beskrivande design med kvalitativ ansats. Tio intensivvårdssjuksköterskor intervjuades med hjälp av semistrukturerade intervjuer. Resultat: Det framkom fem huvudkategorier i resultatet: Definition av begreppet postoperativa luftvägskomplikationer, Att välja omvårdnadsåtgärder, Att ge förebyggande omvårdnad, Att bedöma patientens individuella behov och Att se hinder till att ge omvårdnadsåtgärder. Intensivvårdssjuksköterskorna beskrev att det inte finns några rutiner eller riktlinjer att följa gällande förebyggandet av postoperativa luftvägskomplikationer. De beskrev också att patientens individuella behov ligger till grund för valet av omvårdnadsåtgärder för att förebygga postoperativa luftvägs-komplikationer. Intensivvårdssjuksköterskorna beskrev även olika råd om egenvård som de ger patienterna med syfte att förebygga postoperativa luftvägskomplikationer, bland annat att uppmana dem till att hosta och djupandas och att instruera dem att blåsa i PEEP-ventil*. Slutsats: Studiens resultat belyser avsaknaden av rutiner och känslan av att de postoperativa patienterna är en åsidosatt patientgrupp inom intensivvården samt att intensivvårdssjuksköterskorna saknar tiden till att kunna vårda denna patientgrupp optimalt. Rutiner bör upprättas för att intensivvårdssjuksköterskorna ska veta vilka omvårdnadsåtgärder som behöver sättas in för att förebygga postoperativa luftvägskomplikationer. Nyckelord: Intensivvårdssjuksköterska, omvårdnadsåtgärder, postoperativa luftvägskomplikationer, prevention.   *PEEP- PEEP betyder Positive End Expiratory Pressure (positivt slutexpiratoriskt tryck).  PEEP-ventil = Ventil som patienten andas ut emot, som gör att respirationscykeln startar och slutar med ett positivt tryck i luftvägarna (Gulbrandsen & Stubberud, 2009).
Background: Postoperative respiratory complications are common and can be associated with an increase of mortality, morbidity and costs for society. There are different kinds of nursing actions to prevent postoperative pulmonary complications. Aim: The aim of this study was to describe how intensive care nurses define postoperative respiratory complications, and what kind of nursing actions they perform to prevent these complications among the postoperative patients. Method: The study was performed through a descriptive design with qualitative approach. Semistructured interviews with ten intensive care nurses were conducted. Result: Five categories appeared in the result: Definition of the concept postoperative respiratory complications, To choose nursing actions, To perform preventive care, To assess the patient´s individual needs and To see obstacles to perform nursing actions. The intensive care nurses described that there are no routines to follow in preventing respiratory complications for the postoperative patient. The intensive care nurses also described that they see to the patientens´ individual needs to prevent postoperative respiratory complications and that they give them different self-care advices in order to prevent postoperative respiratory complications, for instance tell the patient to cough, take deep breaths and instruct them how to use a PEEP-tube*. Conclusion: The result of this study showed that there is a lack of routines and that the these patients are breachede within the intensive care and also that the intensive care nurses experience a lack of time to givet hese patientes optimal care. Routines should be established so that intensive care nurses know what kind of nursing action to choose in order to prevent postoperative pulmonary complications. Key words: Intensive care nurse, nursing actions, postoperative respiratory complications, prevention. *PEEP- PEEP means Positive End Expiratory Pressure.  PEEP-tube = Ventilator/tube in which the patient exhales against to make the cycle of respiration start and end onto a positive pressure in the respiratory system (Gulbrandsen & Stubberud, 2009).
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Westerdahl, Elisabeth. "Effects of Deep Breathing Exercises after Coronary Artery Bypass Surgery." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4520.

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Lunardi, Adriana Claudia. "Efeito do treinamento muscular respiratório em indivíduos desnutridos submetidos a cirurgias abdominais altas." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-31082010-172212/.

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Racional: A desnutrição calórico-protêica é um problema de saúde pública mundial e atinge cerca de 40% da população com doenças gastrointestinais candidata a cirurgias abdominais altas eletivas. Objetivos: Avaliar os efeitos do treinamento da musculatura respiratória na função respiratória e na incidência de complicações pulmonares em indivíduos desnutridos submetidos a cirurgias abdominais altas (desfecho primário), após caracterizar a função respiratória em portadores de desnutrição calórico-protéica (desfecho secundário). Métodos: Foram avaliados 122 indivíduos em 2 fases. A etapa inicial foi um estudo longitudinal que avaliou 75 candidatos à cirurgia abdominal alta eletiva que foram divididos em 2 grupos, de acordo com seu estado nutricional: controle (GC, n=36) e desnutridos (GD, n=39). Todos os indivíduos tiveram seus dados clínicos (nutricional e laboratorial), antropométricos e a função respiratória (espirometria, força muscular respiratória e cirtometria) avaliados. A incidência de complicações pulmonares pós-operatórias (CPP) foi contabilizada de maneira cega por avaliadores independentes após o procedimento cirúrgico. Todos os indivíduos receberam sessões diárias de fisioterapia convencional e padronizada após a cirurgia. Na etapa seguinte, foram avaliados 47 desnutridos divididos aleatoriamente em 3 grupos de treinamento: Sham (GSH, n=20), inspiratório (GTI, n=15) e expiratório (GTE, n=12). Os treinamentos inspiratórios e expiratórios foram realizados durante 7 dias com carga linear de 30% da pressão respiratória máxima. As avaliações pré-operatórias e o seguimento pós-operatório foram realizados de maneira similar a etapa inicial do estudo. Resultados: Nossos resultados mostram que os desnutridos apresentam fraqueza dos músculos expiratórios (p<0,001), redução da expansibilidade torácica (p<0,001) e maior incidência de CPP (p=0,05). Além disso, observou-se que quando a desnutrição esta associada à fraqueza da musculatura expiratória há uma maior incidência de CPP (p=0,02). Na etapa do treinamento muscular respiratório, não foi observado ganho de força muscular respiratória ou de expansibilidade torácica em nenhum dos grupos treinados (p>0,05) e não houve diferença na incidência CPP após cirurgias abdominais altas eletivas entre os grupos (p>0,05). Conclusões: Nossos resultados mostram que a desnutrição está associada à fraqueza da musculatura expiratória e à diminuição da expansibilidade torácica e que esses déficits aumentam a incidência de complicações pulmonares após cirurgias abdominais altas eletivas. Porém, não observamos modificação na incidência dessas complicações decorrentes dos treinamentos musculares respiratórios realizados. É possível que isto esteja relacionado ao número amostral e sugerimos futuros estudos para confirmar estes resultados
Background: The protein-energy malnutrition is a very common health problem and around 40% of patients with gastrointestinal disorders candidate for elective upper abdominal surgery present weight loss and malnutrition. Objectives: This is a two phases study and the first phase aimed to compare the incidence of pulmonary complications in controls and malnourished individuals undergoing to upper abdominal surgeries. The second phase aimed to assess the effect of two types of respiratory muscles training in the incidence of pulmonary complications in malnourished individuals. Methods: One-hundred and twenty-two individuals were evaluated in two phases. In the first phase, 75 candidates for elective upper abdominal surgery were divided, based on their nutritional status, into 2 groups: control (CG, n=36) and malnutrition (MG, n=39). Clinical (nutritional and hemogram) and anthropometric data as well as respiratory function (spirometry, respiratory muscles strength and cirtometry) were collected from all patients. The incidence of postoperative pulmonary complications (PPC) was collected after surgery by a blinded independent evaluator. All subjects received daily sessions of conventional physiotherapy standardized. On the second phase, 47 malnourished individuals were randomly divided into 3 groups: Sham (SHG, n=20) and either inspiratory (ITG, n=15) or expiratory training groups (ETG, n=12). Inspiratory and expiratory training were performed with linear load of 30% of maximum respiratory pressure. The preoperative assessments and the postoperative follow up were made on the similar way at the beginning of the study. Results: Our results showed that malnourished individuals present expiratory muscle weakness (p<0.001), reduced chest wall expansion (p<0.001) and higher incidence of PPC (p=0.05). In addition, it was observed that the malnutrition associated with expiratory muscle weakness causes a higher incidence of PPC (p=0.02). During the respiratory muscle training, it was not observed either increase in the respiratory muscle strength or chest wall expansibility in all training groups (p>0.05) and there was no difference in the incidence of PPC after elective upper abdominal surgery among the groups (p>0.05). Conclusions: Our results show that malnutrition is associated with expiratory muscle weakness and decreased chest wall expansion and these deficits increase postoperative pulmonary complications in individuals undergoing to upper abdominal surgeries. The impairment on malnourished subjects respiratory function causes increase in the incidence of postoperative pulmonary complications after elective upper abdominal surgery. However, we did not observe changes in the incidence of complications after respiratory muscle training. It is possible that this fact is related with the sample size and we suggest future studies to confirm these results
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Schnaider, Jerusa. "Influência da força muscular respiratória pré-operatória na evolução clínica após cirurgia de revascularização do miocárdio." Universidade do Estado de Santa Catarina, 2009. http://tede.udesc.br/handle/handle/439.

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Surgical procedures may affect respiratory muscles through various mechanisms. Previous patient´s health conditions may also contribute to increase this dysfunction. The objective of this study was to verify if respiratory muscle strength in the preoperative phase could influence the outcomes after coronary artery bypass graft surgery (CABG). It was an descriptive and prospective, cohort-type study, conducted in the Instituto de Cardiologia de Santa Catarina (ICSC), located in the city of São José/SC. The cohort was composed of male adults of any age and post menopause women waiting for elective RM surgery, without previous history of cardiac surgery, or recent aneurism and unstable angina. 28 patients were consecutively evaluated between the months of August and November of 2008, and the final cohort was composed of 24 individuals: 18 male adults and 6 women. Due to the preoperative evaluation of Respiratory Muscle Strength (RMS) 2 groups were formed: G1, composed of individuals with standard RMS value (n=13); and G2 (n=11), with abnormal RMS results (inspiratory pressure, Pimax, lower than 70% of the predicted value). In inferential statistics, we decided to adopt the Fisher´s exact and Mann-Whitney tests, besides risk calculations for postoperative pulmonary complications (PPC), expressed by Relative Risk measurements (RR) Odds Ratio (OR) and with significance level of 5%. The results show that the groups were homogeneous, showing no significant difference in either the patients preoperative profile in both groups or in the surgical procedures conducted. There was a high prevalence of respiratory muscle dysfunction in preoperative: 46% of the patients had PImax < 70% of the predicted value, 20,83% also presented PEmax <70% of the predicted value and abnormal postoperative spirometry. There was a significant reduction of RMS from pre to postoperative in both groups, where PImax and PEmax were significantly lower in G2 also in post operative. Postoperative evolution data, like mechanical ventilation time, ICU time, postoperative hospitalization, time degree of PPC did not estatistically differ between the groups. It was found an increase in the risk for G2 patients to develop PPC in relation to G1, with RR of 2.36 (IC 95% between 0.7636 and 7.316) and OR of 4.00 (IC 95% between 0.6927 and 23.099), although without statistical confirmation, probably due to the small sample.
O procedimento cirúrgico pode afetar os músculos respiratórios por vários mecanismos, e ainda contribuem para o aumento dessa disfunção as condições prévias dos pacientes. O objetivo da pesquisa foi verificar se a força muscular respiratória na fase pré-operatória poderia influenciar nos desfechos após a cirurgia de revascularização do miocárdio (RM). O estudo foi descritivo e prospectivo, tipo coorte, realizado no Instituto de Cardiologia de Santa Catarina localizado no município de São José/SC. Foram incluídos homens adultos de qualquer idade e mulheres pós-menopausa, aguardando cirurgia de RM eletiva, sem história de cirurgia cardíaca anterior, ou aneurisma e angina instável recente. Avaliou-se 28 pacientes consecutivamente entre os meses de agosto e novembro de 2008, e a amostra final foi composta de 24 indivíduos: 18 adultos homens e 6 mulheres. Em decorrência da avaliação pré-operatória de força muscular respiratória (FMR), formaram-se 2 grupos: G1 constituído por indivíduos com FMR com valores considerados normais (n=13), e G2 (n=11) com resultados anormais de FMR (pressão inspiratória - PImax - menor que 70% do previsto). Na estatística inferencial optou-se pelos testes exato de Fisher e Mann-Whitney, além do cálculo de risco para complicações pulmonares pós-operatórias (CPP), expresso pelas medidas de Risco Relativo (RR) e Odds Ratio (OR), com nível de significância de 5%. Os resultados mostram que os grupos eram homogêneos não havendo diferença significativa nem no perfil pré-operatório dos participantes dos dois grupos, nem quanto aos procedimentos cirúrgicos realizados. Houve alta prevalência de disfunção muscular respiratória no pré-operatório: 46% dos indivíduos tinham PImax < 70% do previsto, 20,83% apresentavam também PEmax <70% do previsto e espirometria pré-operatória anormal. Houve uma redução significativa da FMR do pré para o pós-operatório em ambos os grupos, sendo que PImax e PEmax foram significativamente menores no G2 também no pós-operatório. Dados da evolução pós-operatória como tempo de ventilação mecânica, tempo de internação em UTI, tempo de internação pós-operatória, grau de CPP, não diferiram estatisticamente entre os grupos. Foi encontrado um aumento do risco para os pacientes do G2 desenvolverem CPP em relação ao G1, com RR de 2,364 (IC 95% entre 0,7636 e 7,316) e OR de 4,00 (IC 95% entre 0,6927 e 23,099), porém sem confirmação estatística provavelmente devido a amostra reduzida.
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GAUTHIER, JEROME. "Evaluation du risque de complications pulmonaires apres chirurgie thoracique." Lyon 1, 1992. http://www.theses.fr/1992LYO1M306.

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Bastos, Thaísa Araujo Barreto. "Influência da força muscular respiratória pré-operatória na evolução de pacientes com insuficiência cardíaca submetidos à cirurgia cardíaca." Universidade Federal de Sergipe, 2011. https://ri.ufs.br/handle/riufs/3701.

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Influence of preoperative respiratory muscle strength in the postoperative status of patients with heart failure undergoing cardiac surgery. Thaísa Araujo Barreto Bastos, Aracaju, 2011. Respiratory muscles are essential in moving the chest during breathing, allowing entry and exit of air from the lungs to perform gas exchange, and assists in other maneuvers as in cough. It is known that patients with heart failure have reduced respiratory muscle strength evidenced in the evaluation of maximal respiratory pressures and that the studies have associated respiratory muscle dysfunction preoperatively with the presence of pulmonary complications after surgery for some surgeries. The goal of this research was to investigate the influence of preoperative respiratory muscle strength in pulmonary complications in patients with heart failure undergoing cardiac surgery. From March 2009 to September 2010, 40 patients undergoing cardiac surgery at the Cardiology Department of the Hospital Fundação de Beneficência Hospital de Cirurgia were divided into two groups according to the values of maximal inspiratory pressure (MIP) measured by manometer: group A (n = 21) consisted of patients who had MIP normal and group B (n = 19), patients showed a reduction of the measure. For quantitative variables we used the Student t test, whereas for categorical variables and the statistical test chosen was the chi-square test or Fisher's exact test. Also, we performed an analysis of correlation between the variables of gender, functional classification of the New York Heart Association (NYHA), ejection fraction (LVEF), duration of surgery and cardiopulmonary bypass time in the presence of CPP. The level of significance was 5%. Of the patients, 47.5% showed reduction in respiratory muscle strength, the total rate of pulmonary complications after surgery was 25%, 19% of patients in group A and 31.6% of patients in group B had general pulmonary complications, this difference was not statistically significant (p = 0.29). Regarding the presence of specific complications, group A was 14.3% and 10.5% group B (p = 0.55). There was also no difference in the days of ICU stay and total stay between groups. There was a weak association between these variables and the presence of CPP. In this study, preoperative respiratory muscle dysfunction does not seems to influence the evolution of heart failure patients for the presence of pulmonary complications after cardiac surgery.
Influência da força muscular respiratória pré-operatória na evolução de pacientes com insuficiência cardíaca submetidos à cirurgia cardíaca. Thaísa Araujo Barreto Bastos, Aracaju, 2011. Os músculos respiratórios são essenciais na movimentação do tórax durante a respiração, permitindo a entrada e saída de ar dos pulmões para realização das trocas gasosas, além de auxiliar em outras manobras como na tosse. Sabe-se que pacientes com insuficiência cardíaca apresentam redução da força muscular respiratória evidenciada na avaliação das pressões respiratórias máximas e que os trabalhos vêm associando a disfunção muscular respiratória pré-operatória com a presença de complicações pulmonares no pós-operatório de algumas cirurgias. O objetivo desta pesquisa foi verificar a influência da força muscular respiratória pré-operatória na incidência de complicações pulmonares em pacientes com insuficiência cardíaca submetidos à cirurgia cardíaca. De março de 2009 a setembro de 2010, 40 pacientes submetidos à cirurgia cardíaca no serviço de cardiologia da Fundação de Beneficência Hospital de Cirurgia foram distribuídos em dois grupos, de acordo com os valores da pressão inspiratória máxima avaliada por meio da manovacuometria: grupo A (n=21), composto de pacientes que apresentaram PImáxima normal; e grupo B (n=19), com pacientes que apresentaram redução dessa medida. Para a análise estatística das variáveis quantitativas foi utilizado o teste T de student, enquanto que para as variáveis categóricas o teste estatístico escolhido foi o qui-quadrado ou o exato de Fisher. Ainda foi realizada uma análise de correlação entre as variáveis gênero, classificação funcional da New York heart association (NYHA), fração de ejeção do ventrículo esquerdo (FEVE), tempo de cirurgia e tempo de circulação extracorpórea com a presença de CPP. O nível de significância considerado foi 5%. Dos pacientes da amostra 47,5% apresentaram redução da força muscular respiratória; a taxa de complicações pulmonares total no pós-operatório foi de 25%; 19% dos pacientes do grupo A e 31,6% dos pacientes do grupo B apresentaram complicações pulmonares gerais, sendo esta diferença não significativa estatisticamente (p=0,29). Quanto à presença de complicações específicas, o grupo A teve 14,3% e o grupo B 10,5% (p= 0,55). Também não houve diferença quanto aos dias de internação em UTI e total (UTI + enfermaria) entre os grupos. Observou-se uma fraca associação entre a as variáveis estudadas e a presença de CPP. Nesse trabalho, a disfunção muscular respiratória pré-operatória parece não ter influenciado na incidência de complicações pulmonares no pós-operatório de cirurgia cardíaca em pacientes com insuficiência cardíaca.
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Cunha, Maria Inês Fonseca. "Postoperative respiratory complications and Obstructive Sleep Apnea Syndrome." Dissertação, 2013. https://repositorio-aberto.up.pt/handle/10216/72143.

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Cunha, Maria Inês Fonseca. "Postoperative respiratory complications and Obstructive Sleep Apnea Syndrome." Master's thesis, 2013. https://repositorio-aberto.up.pt/handle/10216/72143.

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Queirós, Catarina Sousa Duque Soares. "Postoperative respiratory complications and perioperative strategies to prevent them: a review." Dissertação, 2015. https://repositorio-aberto.up.pt/handle/10216/78856.

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Queirós, Catarina Sousa Duque Soares. "Postoperative respiratory complications and perioperative strategies to prevent them: a review." Master's thesis, 2015. https://repositorio-aberto.up.pt/handle/10216/78856.

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Books on the topic "Postoperative respiratory complications"

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1936-, Geha Alexander S., and Cohen Lawrence S, eds. House officer guide to ICU care: Fundamentals of management of the heart and lungs. 2nd ed. New York: Raven Press, 1994.

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1936-, Geha Alexander S., ed. House officer guide to ICU care: The cardiothoracic surgical patient. Rockville, Md: Aspen Systems Corp., 1985.

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H, Hanowell Leland, and Junod Forrest L, eds. Pulmonary care of the surgical patient. Mt. Kisco, N.Y: Futura, 1994.

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Armstrong, Sarah L., and Gary M. Stocks. Postoperative analgesia after caesarean delivery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713333.003.0024.

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Caesarean delivery (CD) is one of the most common operations in the world and providing effective pain relief is important not only for humanitarian reasons but also to speed up recovery and reduce postoperative complications. An understanding of the anatomy and physiology of pain transmission after CD has led to a multimodal approach to analgesia. This involves combining analgesics which work by different mechanisms resulting in an additive effect whilst at the same time reducing side effects. In contemporary practice, most CDs are carried out under neuraxial anaesthesia and neuraxial techniques using either intrathecal or epidural opioids have become central to the provision of effective postoperative analgesia. They reduce the need for systemic opioid analgesia and have few side effects, respiratory depression being the most significant but extremely uncommon. In circumstances where it is not possible to use neuraxial analgesia, for example, after general anaesthesia, other techniques such as intravenous patient-controlled analgesia using opioids and the transversus abdominis plane block have been shown to be effective. As part of the multimodal analgesic approach, many patients will require systemic analgesics to further improve pain relief and to limit side effects. Paracetamol and non-steroidal anti-inflammatory drugs are now widely established in the management of postoperative CD pain where they have been shown to potentiate opioid effects, decrease opioid consumption, reduce side effects, and complement the somatic pain relief provided by opioids. As part of a step-down approach after primary management with neuraxial or intravenous opioids, oral opioids are often required as part of a multimodal regimen.
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Krashin, Daniel, Natalia Murinova, and Alan D. Kaye. Prevention of Adverse Effects in Perioperative Pain Management for General and Plastic Surgeons. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0018.

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Postoperative pain management is a key part of perioperative care. Inadequately controlled pain contributes to poor outcomes and patient satisfaction. Overmedication with opioids for postoperative pain also leads to complications and slows recovery. Perioperative pain care starts with thorough evaluation at the preoperative visit. Multimodal pain treatment reduces the reliance on opioids and tends to improve outcomes. Many complicating factors, including pregnancy, comorbid psychological and medical conditions, addiction, and chronic opioid therapy need to be identified and addressed in a personalized pain plan. Complications including delirium and opioid-induced respiratory suppression are also discussed.
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Rovner, Michelle Sher. Post-Tonsillectomy Bleeding. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0080.

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Post-tonsillectomy bleeding is a well-described complication that can rapidly evolve into one of the most challenging clinical situations in anesthesia. Tonsillectomy and adenoidectomy is one of the most common pediatric surgical procedures. A frequent indication for this procedure is adenotonsillar hyperplasia associated with obstructive sleep apnea. These children may be very challenging to care for and may have significant respiratory and fluid management issues postoperatively. This situation requires immediate attention and action with regard to resuscitation in a hypovolemic patient in combination with the challenges of a potentially difficult airway. This chapter discusses obstructive sleep apnea and its associated increased risk of postoperative complications with regard to tonsillectomy and adenoidectomy. It also reviews risk factors for postoperative tonsillar bleeding and the considerations in treating these children.
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Ryan, Laura, and Paul Hopkins. Obstructive Sleep Apnea. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0011.

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Adenotonsillectomy is one of the most commonly performed surgeries in children and is the mainstay treatment for obstructive sleep apnea (OSA). Children with OSA have a higher risk of perioperative respiratory morbidity. Diagnosis of OSA is made by overnight polysomnography, but this resource is rare and expensive so children at risk for OSA must be identified based on parental history. Patients with risk factors for postoperative respiratory complications may need to be monitored in the hospital overnight. Anesthetic challenges associate with adenotonsillectomy include perioperative analgesia, prevention and treatment of postoperative nausea and vomiting, risk of airway fire, and management of airway obstruction.
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Mills, Gary H. Pulmonary disease and anaesthesia. Edited by Philip M. Hopkins. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0082.

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Respiratory adverse events are the commonest complications after anaesthesia and have profound implications for the recovery of the patient and their subsequent health. Outcome prediction related to respiratory disease and complications is vital when determining the risk:benefit balance of surgery and providing informed consent. Surgery produces an inflammatory response and pain, which affects the respiratory system. Anaesthesia produces atelectasis, decreases the drive to breathe, and causes muscle weakness. As the respiratory system ages, closing capacity increases and airway closure becomes an increasing issue, resulting in atelectasis. Increasing comorbidity and polypharmacy reduces the patient’s ability to eliminate drugs. The proportion of major operations on older frailer patients is rising and postoperative recovery becomes more complicated and the demand for critical care rises. At the same time, the population is becoming more obese, producing rapid decreases in end-expiratory lung volume on induction, together with a high incidence of sleep-disordered breathing. Despite this, many high-risk patients are not accurately identified preoperatively, and of those that are admitted to critical care, some are discharged and then readmitted to the intensive care unit with complications. Respiratory diseases may lead to increases in pulmonary vascular resistance and increased load on the right heart. Some lung diseases are primarily fibrotic or obstructive. Some are inflammatory, autoimmune, or vasculitic. Other diseases relate to the drive to breathe, the nerve supply to, or the respiratory muscles themselves. The range of types of respiratory disease is wide and the physiological consequences of respiratory support are complex. Research continues into the best modes of respiratory support in theatre and in the postoperative period and how best to protect the normal lung. It is therefore essential to understand the effects of surgery and anaesthesia and how this impacts existing respiratory disease, and the way this affects the balance between load on the respiratory system and its capacity to cope.
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Frawley, Geoff. Former Premature Infant for Hernia Repair. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0047.

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Inguinal hernia repair is the most common surgery in ex-premature infants. These infants have demonstrated a significantly higher incidence of postoperative apnea with risk inversely related to gestational age. Both awake regional anesthesia without sedation and general anesthesia have been described in this age group, and each has advantages and drawbacks. In the case of awake regional techniques, the major drawback is the block failure rate which is directly related to provider experience. In the case of general anesthesia, the limiting factor is the much higher rate of postoperative respiratory complications including apnea and hypoventilation. The rate of respiratory complications (which has been reported to be as high as 30% with halothane and enflurane) is between 5% and 10% with sevoflurane and desflurane and is inversely related to gestational age. The association between neonatal exposure to volatile anesthesia and subsequent neurodevelopmental delay has promoted use of regional anesthesia when possible.
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Lazar, Alina. Congenital Pulmonary Airway Malformation. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0015.

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Respiratory distress in infants may be caused by perinatal events and physiologic changes (e.g., lung immaturity, meconium aspiration, and persistent pulmonary hypertension); infectious processes; cardiovascular, neurologic, and metabolic abnormalities; as well as congenital lung abnormalities. Some of these may coexist, further complicating the diagnosis, clinical course, and management of the affected infant. Sound anesthetic management of congenital lung abnormalities requires a clear understanding of the pathophysiology of lung lesions and, in particular, the consequences of positive-pressure ventilation in patients with cystic and emphysematous lesions. Also critical is an appreciation for the physiologic differences in children undergoing thoracic surgery, indications for one-lung ventilation, age-appropriate lung isolation techniques, potential respiratory and cardiovascular complications that may occur during pediatric thoracic surgery, and the optimal choices for postoperative analgesia.
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Book chapters on the topic "Postoperative respiratory complications"

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Vargas, Maria, Yuda Sutherasan, and Paolo Pelosi. "Postoperative Respiratory Complications." In Anaesthesia, Pharmacology, Intensive Care and Emergency A.P.I.C.E., 99–112. Milano: Springer Milan, 2013. http://dx.doi.org/10.1007/978-88-470-5516-2_8.

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Obelez, Yulia, and Karen B. Domino. "Postoperative Respiratory Complications." In Essentials of Neurosurgical Anesthesia & Critical Care, 493–99. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-17410-1_76.

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Nurok, Michael, Oren Friedman, and Erik R. Dong. "Respiratory Complications and Management After Adult Cardiac Surgery." In Postoperative Critical Care for Adult Cardiac Surgical Patients, 327–63. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-75747-6_11.

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Brock-Utne, John G. "Case 16: Postoperative Respiratory Complications in a Neonate." In Near Misses in Pediatric Anesthesia, 47–48. New York, NY: Springer New York, 2013. http://dx.doi.org/10.1007/978-1-4614-7040-3_16.

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Fernandez-Bustamante, Ana, Juraj Sprung, Rodrigo Cartin-Ceba, Toby N. Weingarten, and David O. Warner. "The Aging Respiratory System: Strategies to Minimize Postoperative Pulmonary Complications." In Geriatric Anesthesiology, 179–96. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-66878-9_12.

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Bharadwaj, Devika, and Keshav Goyal. "Postoperative Respiratory Complications and Ventilatory Strategies in Pediatric Neurosurgical Patients." In Fundamentals of Pediatric Neuroanesthesia, 647–65. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-16-3376-8_39.

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Dietz, Andreas. "The Surgical Approach to Elderly Patients with HNSCC." In Critical Issues in Head and Neck Oncology, 111–18. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63234-2_8.

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AbstractDespite the fact that elderly people are the main incidental and continuously growing patient group with head and neck cancer, prospective trials focusing on special issues regarding head and neck surgery in elderlies are missing. To avoid complications during and after surgery in that patient category, comprehensive evaluation of functional status, comorbidities, performance status, social support and mental condition is mandatory. Regarding functional parameters, cardiac and respiratory conditions play a major role for any primary surgical procedure. Nevertheless, other comorbidities, medication and patients view on self-determination have carefully to be taken into consideration. It has repeatedly been shown that fit elderly individuals may benefit from intensive therapies like reconstructive surgery with microvascular free tissue transfer, concurrent chemoradiotherapy in the locoregionally advanced disease setting, and even from the standard first- and second-line palliative systemic therapies. Since it is well known that tolerance of systemic nonsurgical treatments in elderly people is less and therefore death from noncancer-related causes in that population is higher, moderate surgical procedures can be even more effective regarding quality of life in situations facing higher comorbidities, or functional constraints with limited life expectancy compared to nonsurgical standard approaches. Older people usually are at increased risk of postoperative complications. In particular, organ failure progresses much faster in multiple organ failure. The preoperative clarification of comorbidity for the avoidance of surgical complications is therefore of major importance. Close coordination with anesthesia and rapid postoperative mobilization are essential for this. Decision-making and treatment based on specific assessment in an experienced multidisciplinary team is key.
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Ali, Zulfiqar, Yasir N. Shah, and Hemanshu Prabhakar. "Postoperative respiratory complications." In Manual of Neuroanesthesia, 345–54. CRC Press, 2017. http://dx.doi.org/10.1201/9781315154367-54.

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Porembka, David. "Postoperative Respiratory Failure." In Complications in Anesthesia, 347–51. Elsevier, 2007. http://dx.doi.org/10.1016/b978-1-4160-2215-2.50091-0.

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Lane, Jeffrey L. "Postoperative Respiratory Insufficiency." In Complications in Anesthesia, 877–80. Elsevier, 2007. http://dx.doi.org/10.1016/b978-1-4160-2215-2.50225-8.

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Conference papers on the topic "Postoperative respiratory complications"

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"Preoperative Respiratory Physiotherapy and Postoperative Pulmonary Complications in CABG." In Sept. 8-10, 2017 Istanbul (Turkey). URST, 2017. http://dx.doi.org/10.17758/urst.u0917241.

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Mikhail, Kontorovich, and Syskov Konstantin. "The prevention of postoperative respiratory complications in lung surgery." In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa2505.

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Swisher, MW, R. Jonas, X. Tian, CW Lo, and L. Leatherbury. "Increased Postoperative Respiratory Complications in Patients with Congenital Heart Disease and Heterotaxy." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a1223.

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Soto-Martinez, Manuel E., Greta M. Palmer, Ian Torode, and Colin F. Robertson. "Postoperative Respiratory complications Following Corrective Scoliosis Surgery In A Group of High Risk Children." In American Thoracic Society 2010 International Conference, May 14-19, 2010 • New Orleans. American Thoracic Society, 2010. http://dx.doi.org/10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a3898.

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Hokari, Satoshi, Yasuyoshi Ohshima, Kenjiro Shima, Rika Moriya, Toshiyuki Koya, Hiroshi Kagamu, Hiroki Tsukada, Toshinori Takada, and Toshiaki Kikuchi. "Preoperative screening with respiratory failure risk index reduces postoperative pulmonary complications in esophagectomy patients." In Annual Congress 2015. European Respiratory Society, 2015. http://dx.doi.org/10.1183/13993003.congress-2015.pa3732.

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Tašková, Alice, Marie Drösslerová, Kristian Brat, Vladislav Hytych, and Martina Vašáková. "Preoperative evaluation of patients undergoing lung resection using cardiopulmonary exercise testing in predicting postoperative respiratory complications." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa2764.

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Tyagi, Vijay Narain, Aditya Singh, Sanjeev Saxena, Shivkant Agarwal, Rahul Kathuria, Prashant Bendre, and Amit Garg. "Preoperative FENO(Fractional Exhaled Nitric Oxide) assessment as a predictor of postoperative respiratory complications in case of cardiac surgery(CABG)." In ERS International Congress 2020 abstracts. European Respiratory Society, 2020. http://dx.doi.org/10.1183/13993003.congress-2020.2183.

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Pellet, Mathieu, Pierre Melchior, Youssef Abdelmoumen, and Alain Oustaloup. "Fractional Thermal Model of the Lungs Using Havriliak-Negami Function." In ASME 2011 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2011. http://dx.doi.org/10.1115/detc2011-48095.

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This paper is about fractional system identification of a thermal model of the lungs. Usually, during open-heart surgery, an extracorporeal circulation (ECC) is carried out on the patient. In order to plug the artificial heart/lung machine on the blood stream, the lungs are disconnected from the circulatory system. This may results in postoperative respiratory complications. A method to protect the lungs has been developed by surgeon and anesthetist. It is called: bronchial hypothermia. The aim is to cool the organ in order to slow down its deterioration. Unfortunately the thermal properties of the lungs are not well-known yet. Mathematical models are useful and needed in order to improve the knowledge of these organs. As proved by several previous works, fractional models are especially appropriate to model thermal systems (model compacity, accuracy) and the dynamic of fractal systems. Thus, fractional models of the lungs have been determined using time domain system identification with the Havriliak-Negami function. A comparison with integer order models was also carried out. The aim of this paper is to present the results of this study.
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Giri, Shveta, Swati Shah, Rupinder Sekhon, and Sudhir Rawal. "Clinical outcomes of cytoreductive surgery and HIPEC in advanced and recurrent epithelial ovarian cancers with peritoneal carcinomatosis." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685311.

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Introduction: The role of surgery for Peritoneal carcinomatosis (PC) has slowly evolved from palliation to potential curative intent. Attempting to remove all visible tumor deposits, “surgical cytoreduction” (CRS) was reported in 1930s for ovarian cancer and eventually became an accepted therapy with proven survival benefit. The new approach of combining CRS and Hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal metastasis offer hope for long term survival in this group of patients. The risk and benefit of this approach continued to be debated. A prospective study was conducted to understand the perioperative outcomes of CRS & HIPEC. Aim: To evaluate the perioperative outcomes associated with CRS & HIPEC in Advanced and Recurrent Epithelial Ovarian Cancer with PC. Methods: Prospective analysis of patients undergoing CRS & HIPEC from November 2014 to July 2015 was done. Inclusion criteria included localized disease in peritoneal cavity, no distant metastasis and PS <2. Grade 3/4 complications from day of surgery until 30 days postoperatively were recorded. Results: We performed CRS & HIPEC in 20 patients from Nov 2014 to June 2015. HIPEC Plus regimens included Cisplatin (50 mg/m2) and Lipodox (15 mg/m2) intraperitoneally and Ifosphamide (1300 mg/m2) & Mesna (260 mg/m2) Infusion time was 90 minutes with a temperature range of 41-43 °C. Out of 20 patients 6 (30%) underwent primary debulking surgery and 14(70%) underwent secondary debulking surgery. PCI score ranged from 2-26 (mean 13.65). Mean operating time was 6.42 hrs and average blood loss was 1046 ml. Average hospital stay was 8 days and SICU stay was 4.9 days (range 3-14 days). Total 26 adverse events were observed of which grade 1 were 11 (42%), grade 2 were 8 (30%), grade were 3 (11.5%) and grade4 were 2 (8%). Most common complication was hematological (8) followed by respiratory (6), sepsis (4) renal (2), GI (2). 4 patients (5 events) developed grade3 or 4 complications in the form of septicaemia, pulmonary embolism, GI fistula of which 2 patients expited and remaining recovered although required prolonged hospitalization. Increased morbidity were observed in cases with symptomatic relapse, higher PCI score and CA 125 level higher than 250 U/ml. Most of the adverse events were grade 1 and 2 and were managed by observation only or GCSF support, transfusions and other minor interventions. The combined grade 3-4 morbidity was 20% (4out of 20) which consisted of neutropenia, infection and respiratory complications. One patient required relaparotomy and two patients expired attributed to pulmonary embolism and septicaemia respectively. Conclusion: Enthusiasm associated with improvement in survival is often dampened by increased perioperative mortality and morbidity figures and therefore CRS & HIPEC has not yet been considered standard of care by many centres. HIPEC after extensive cytoreductive surgery for ovarian cancer is a procedure whth acceptable morbidity that patients can tolerate. More follow up is needed to determinr the effect of HIPEC on survival. Till such time more data are obtained by way of larger randomised trials, this approach remains investigational.
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Giri, Shveta, Swati Shah, Rupinder Sekhon, and Sudhir Rawal. "Clinical outcomes of cytoreductive surgery and HIPEC in advanced and recurrent epithelial ovarian cancers with peritoneal carcinomatosis." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685300.

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Introduction: The role of surgery for peritoneal carcinomatosis (PC) has slowly evolved from palliation to potential curative intent. Attempting to remove all visible tumor deposits, “surgical cytoreduction” (CRS) was reported in 1930s for ovarian cancer and eventually became an accepted therapy with proven survival benefit. The new approach of combining CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat peritoneal metastasis offer hope for long term survival in this group of patients. The risk and benefit of this approach continued to be debated. A prospective study was conducted to understand the perioperative outcomes of CRS and HIPEC. Aim: To evaluate the perioperative outcomes associated with CRS and HIPEC in Advanced and Recurrent Epithelial Ovarian Cancer with PC. Method: Prospective analysis of patients undergoing CRS and HIPEC from November 2014 to July 2015 was done. Inclusion criteria included localized disease in peritoneal cavity, no distant metastasis and PS <2. Grade 3/4 complications from day of surgery until 30 days postoperatively were recorded. Results: We performed CRS and HIPEC in 20 patients from November 2014 to June 2015. HIPEC Plus regimens included Cisplatin (50 mg/m2) and Lipodox (15 mg/m2) intraperitoneally and Ifosphamide (1300 mg/m2) and Mesna (260 mg/m2). Infusion time was 90 minutes with a temperature range of 41-43°C. Out of 20 patients 6 (30%) underwent primary debulking surgery and 14 (70%) underwent secondary debulking surgery. PCI score ranged from 2-26 (mean 13.65). Mean operating time was 6.42 hrs and average blood loss was 1046 ml. Average hospital stay was 8 days and SICU stay was 4.9 days (range 3-14 days). Total 26 adverse events were observed of which grade 1 were 11 (42%), grade 2 were 8 (30%), grade were 3 (11.5%) and grade 4 were 2 (8%). Most common complication was hematological (8) followed by respiratory (6), sepsis (4) renal (2), GI (2). 4 patients (5 events) developed grade 3 or 4 complications in the form of septicaemia, pulmonary embolism, GI fistula of which 2 patients expited and remaining recovered although required prolonged hospitalization. Increased morbidity were observed in cases with symptomatic relapse, higher PCI score and CA 125 level higher than 250 U/ml. Most of the adverse events were grade 1 and 2 and were managed by observation only or GCSF support, transfusions and other minor interventions. The combined grade 3-4 morbidity was 20% (4 out of 20) which consisted of neutropenia, infection and respiratory complications. One patient required relaparotomy and two patients expired attributed to pulmonary embolism and septicaemia respectively. Conclusion: Enthusiasm associated with improvement in survival is often dampened by increased perioperative mortality and morbidity figures and therefore CRS and HIPEC has not yet been considered standard of care by many centres. HIPEC after extensive cytoreductive surgery for ovarian cancer is a procedure whth acceptable morbidity that patients can tolerate. More follow up is needed to determinr the effect of HIPEC on survival. Till such time more data are obtained by way of larger randomised trials, this approach remains investigational.
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