Anesthesia & Clinical Research
Open Access

Abstract

Postoperative Pulmonary Complications: An Epidemiological, Risk Factors and Prevention Review

Ana T Duarte and Humberto S Machado

Introduction: Current knowledge suggests that pulmonary complications are a frequent entity in the postoperative period, with special risk after lung surgery. They are associated with high rates of morbidity and mortality and acute respiratory distress syndrome is a common cause of respiratory failure. These complications have a significant impact on the economy with prolonged hospital stay and increased number of hospital readmissions.

Objectives: To conduct a non-systematic literature review related to the topic of postoperative pulmonary complications, regarding its epidemiology and clinical impact, modifiable and non-modifiable risk factors and preventive strategies.

Methods: Electronic databases such as PubMed, Medline and Google scholar, were used with the keywords listed below. The MeSH terms used were: postoperative complications, acute respiratory distress syndrome and acute lung injury. Accordingly, the review was conducted between the years 2009 and 2015.

Results: The etiology of postoperative pulmonary complications is multifactorial. Modifiable risk factors (smoking and drinking habits, respiratory infection in last month, prolonged surgery) or non-modifiable (advanced age, chronic obstructive pulmonary disease, congestive heart failure) may be involved in the development of postoperative pulmonary complications and should be recognized early to assess the patients’ risk. Preventive strategies can be instituted pre, intra or postoperatively, acting on modifiable risk factors (such as cessation of alcohol consumption and smoking habits) and optimizing those which are not, by training inspiratory muscles preoperatively or using ventilatory strategies such as low tidal volume and incentive spirometry.

Conclusion: The clinical and social consequences of postoperative pulmonary complications are huge and the prevention of its high incidence continues to be a growing challenge. Preventive strategies should be systematically applied in order to achieve better results.