Comprehensive strategies for preoperative pulmonary risk evaluation and management.

IF 2.5 Q2 RESPIRATORY SYSTEM
Hyo Jin Lee, Hyun Woo Lee
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引用次数: 0

Abstract

Postoperative pulmonary complications (PPCs) significantly increase morbidity and mortality in surgical patients, particularly those with pulmonary conditions. The incidence of PPCs varies widely, influenced by surgery type, patient age, smoking status, and comorbidities like chronic obstructive pulmonary disease (COPD) and congestive heart failure. Preoperative pulmonary function tests and chest radiographs, while critical for lung resection surgery, should be selectively used based on individual risk factors. Effective risk stratification models, including ASA classification, Arozullah Respiratory Failure Index, Gupta Calculators, and ARISCAT model, aid in predicting PPCs. Key strategies to reduce PPCs involve preoperative optimization of pulmonary conditions, smoking cessation, and respiratory rehabilitation. In COPD and asthma patients, maintaining optimal disease control through inhaled therapies, systemic corticosteroids, and preoperative respiratory exercises is crucial. Anemia and hypoalbuminemia are notable predictors of PPCs, warranting careful management. The type and duration of anesthesia significantly impact PPC risk, with regional anesthesia preferred over general anesthesia when feasible. Comprehensive preoperative evaluation and tailored interventions are essential to improve surgical outcomes and reduce PPC incidence. Further study involving domestic patients is needed to refine national guidelines for managing patients at risk of PPCs.

术前肺部风险评估和管理的综合策略。
术后肺部并发症(PPCs)大大增加了手术患者的发病率和死亡率,尤其是那些患有肺部疾病的患者。肺部并发症的发生率差异很大,受手术类型、患者年龄、吸烟状况以及慢性阻塞性肺病(COPD)和充血性心力衰竭等合并症的影响。术前肺功能检查和胸片虽然对肺切除手术至关重要,但应根据个体风险因素有选择性地使用。有效的风险分层模型,包括 ASA 分类、Arozullah 呼吸衰竭指数、Gupta 计算器和 ARISCAT 模型,有助于预测 PPC。减少 PPC 的关键策略包括术前优化肺部条件、戒烟和呼吸康复。对于慢性阻塞性肺病和哮喘患者,通过吸入疗法、全身性皮质类固醇和术前呼吸运动来保持最佳的疾病控制至关重要。贫血和低白蛋白血症是 PPCs 的显著预测因素,需要谨慎处理。麻醉类型和持续时间对 PPC 风险有显著影响,在可行的情况下,区域麻醉比全身麻醉更可取。全面的术前评估和有针对性的干预措施对于改善手术效果和降低 PPC 发生率至关重要。需要对国内患者进行进一步研究,以完善管理有 PPC 风险的患者的国家指导方针。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.30
自引率
0.00%
发文量
42
审稿时长
12 weeks
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