Perioperative pulmonary complications

Abstract

Pulmonary complications are prevalent and significantly affect both patients and health services. Rates of postoperative pulmonary complications (PPCs) will probably rise in a surgical population consisting of increasingly frail older patients with co-morbid conditions. In an attempt to reduce variability in the literature a standardized and robust definition of PPCs has been offered, with accompanying diagnostic criteria. Changes in pulmonary physiology perioperatively render patients susceptible to developing areas where ventilation is not matched to perfusion, leading to hypoxaemia and further complications. Risk factors can be classified into patient factors, procedural factors and physiological factors. Prevention strategies focus on optimizing modifiable risk factors and employing anaesthetic and surgical techniques that confer the least impact on respiratory function. Postoperative management includes optimal multimodal analgesia to facilitate breathing exercises and mobilization. Non-invasive ventilation strategies and high-flow nasal oxygen can reduce reintubation rates in individuals with postoperative hypoxia.