Evaluation and Prevention of Perioperative Respiratory Failure
Abstract
:1. Introduction
2. Preoperative Period
2.1. Screening Tests
- normal, healthy patient;
- patient with mild systemic disease;
- patient with severe systemic disease;
- patient with severe systemic disease that is a constant threat to life;
- patient not expected to survive without the operation;
- patient is brain-dead and their organs are being removed for donor purposes.
2.2. Evaluation
- (1)
- To estimate the likelihood of perioperative morbidity and mortality and contribute to preoperative risk assessment.
- (2)
- To inform the processes of multidisciplinary shared decision-making and consent.
- (3)
- To guide clinical decisions about the most appropriate level of perioperative care (ward vs. critical care).
- (4)
- To direct preoperative referrals/interventions to optimize comorbidities.
- (5)
- To identify previously unsuspected pathology.
- (6)
- To evaluate the effects of neoadjuvant cancer therapies, including chemotherapy and radiotherapy.
- (7)
- To guide prehabilitation and rehabilitation training programs.
- (8)
- To guide intraoperative anesthetic practice [27].
2.3. Management
- A.
- Preoperative Considerations and Specific Populations
- B.
- Intraoperative Management
- C.
- Postoperative Care
- (i).
- Bronchospasm
- (ii).
- Hypoventilation
- (iii).
- Acute upper airway obstruction
2.4. Prevention of Postoperative Respiratory Failure on Hospital Wards
3. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Score Components | Risk Score | |
---|---|---|
Age | ≤50 years | 0 |
51–80 years | 3 | |
>80 years | 16 | |
Preoperative oxygen saturation | ≥96% | 0 |
91–95% | 8 | |
≤90% | 24 | |
Respiratory infection in past 1 month | No | 0 |
Yes | 17 | |
Preoperative hemoglobin < 10 g/dL | No | 0 |
Yes | 11 | |
Incision | Peripheral incision | 15 |
Upper abdominal incision | 15 | |
Intrathoracic incision | 24 | |
Surgery duration | <2 h | 0 |
2–3 h | 16 | |
>3 h | 23 | |
Emergency procedure | No | 0 |
Yes | 8 | |
Risk | ARISCAT Score | |
Low | <26 | |
Intermediate | 26–44 | |
High | ≥45 |
STOP | |
---|---|
Snoring | Do you SNORE loudly (louder than talking or loud enough to be heard through a closed door)? |
Tiredness | Do you often feel TIRED, fatigued, or sleepy during daytime? |
Observed apnea | Has anyone OBSERVED you stop breathing during your sleep? |
Pressure | Do you have or are you being treated for high blood PRESSURE? |
BANG | |
BMI | BMI more than 35 kg/m2? |
Age | AGE over 50 years old? |
Neck | NECK circumference > 16 inches (40 cm) |
Gender | GENDER: male? |
High risk for OSA | 5–8 positive responses |
Medium risk for OSA | 3–4 positive responses |
Low risk for OSA | 0–2 positive responses |
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Palermo, J.; Tingey, S.; Khanna, A.K.; Segal, S. Evaluation and Prevention of Perioperative Respiratory Failure. J. Clin. Med. 2024, 13, 5083. https://doi.org/10.3390/jcm13175083
Palermo J, Tingey S, Khanna AK, Segal S. Evaluation and Prevention of Perioperative Respiratory Failure. Journal of Clinical Medicine. 2024; 13(17):5083. https://doi.org/10.3390/jcm13175083
Chicago/Turabian StylePalermo, Jacqueline, Spencer Tingey, Ashish K. Khanna, and Scott Segal. 2024. "Evaluation and Prevention of Perioperative Respiratory Failure" Journal of Clinical Medicine 13, no. 17: 5083. https://doi.org/10.3390/jcm13175083