Clinical and economic burden of postoperative pulmonary complications: Patient safety summit on definition, risk-reducing interventions, and preventive strategies

Aryeh Shander, Lee A. Fleisher, Philip S. Barie, Luca M. Bigatello, Robert N. Sladen, Charles B. Watson

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: Postoperative pulmonary complications are a major contributor to the overall risk of surgery. We convened a patient safety summit to discuss ways to enhance physician awareness of postoperative pulmonary complications, advance postoperative pulmonary complications as a substantive public health concern demanding national attention, recommend strategies to reduce the deleterious impact of postoperative pulmonary complications on clinical outcomes and healthcare costs, and establish an algorithm that will help identify patients who are at increased risk for postoperative pulmonary complications. Data Sources: We conducted PubMed searches for relevant literature on postoperative pulmonary complications in addition to using the summit participantsÊ1/4 experience in the management of patients with postoperative pulmonary complications. DATA SYNTHESIS:: Postoperative pulmonary complications are common, are associated with increased morbidity and mortality, and adversely affect financial outcomes in health care. A multifaceted approach is necessary to reduce the incidence of postoperative pulmonary complications. Identifying a measurable marker of risk will facilitate the targeted implementation of risk-reduction strategies. Conclusions: The most practicable marker that identifies patients at highest risk for postoperative pulmonary complications is the need for postoperative mechanical ventilation of a cumulative duration >48 hrs.

Original languageEnglish (US)
Pages (from-to)2163-2172
Number of pages10
JournalCritical care medicine
Volume39
Issue number9
DOIs
StatePublished - Sep 2011

Keywords

  • biofilm
  • endotracheal tube
  • microaspiration
  • postoperative pneumonia
  • postoperative pulmonary complications
  • ventilator-associated pneumonia

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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