Predicting postoperative pulmonary complications in high-risk populations

Toby N. Weingarten, Daryl J. Kor, Bhargavi Gali, Juraj Sprung

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

Purpose of Review: Our objective is to describe prediction models for surgical patients who have suspected obstructive sleep apnea (OSA) at risk for postoperative respiratory complications and for surgical patients at risk for postoperative acute respiratory distress syndrome (ARDS). Recent Findings: Because of the increased rate of severe perioperative respiratory complications in patients with OSA, the American Society of Anesthesiologists issued practice guidelines for perioperative management. When OSA is diagnosed preoperatively, the rate of postoperative pulmonary complications is low and not associated with OSA severity. However, OSA continues to be an important risk because a substantial proportion of patients in the contemporary surgical population have undiagnosed OSA. Strategies based on preoperative and immediate postoperative clinical signs and symptoms can help identify patients with a high likelihood of OSA, postoperative desaturations, and pulmonary complications. ARDS is another serious postoperative complication associated with high mortality rate and limited treatment options, and its prevention is critical. Practice changes have led to a dramatic reduction in ARDS incidence. A recently developed prediction model can help identify high-risk patients. Summary: Evidence is emerging that early identification of modifiable risk factors and implementation of 'protective' management strategies may lead to reduction of severe postoperative pulmonary complications.

Original languageEnglish (US)
Pages (from-to)116-125
Number of pages10
JournalCurrent Opinion in Anaesthesiology
Volume26
Issue number2
DOIs
StatePublished - Apr 2013

Keywords

  • acute respiratory distress syndrome
  • hypercapnic respiratory failure
  • hypoxic respiratory failure
  • obstructive sleep apnea
  • prediction scores

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Predicting postoperative pulmonary complications in high-risk populations'. Together they form a unique fingerprint.

Cite this