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 patients at risk Respiratory complications of anaesthesia

استعرض الموضوع السابق استعرض الموضوع التالي اذهب الى الأسفل 
كاتب الموضوعرسالة
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عدد الرسائل : 171
العمر : 38
العمل/الترفيه : Anesthesiologist
تاريخ التسجيل : 09/07/2010

مُساهمةموضوع: patients at risk Respiratory complications of anaesthesia   الخميس أكتوبر 23, 2014 8:18 pm



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Patients at risk Respiratory complications of anaesthesia:

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1-diseas

COPD

Congestive heart failure



2-Obese



3-surgery type



Aortic aneurysm repair

Thoracic surgery

Abdominal surgery

Upper abdominal surgery

Neurosurgery

Head and neck surgery

Emergency surgery

Vascular surgery



Major intracranial surgery & Thoracic surgery > Upper abdominal surgery



Upper abdominal surgery > Lower abdominal surgery



Lower abdominal surgery > Limb surgery





4-Prolonged bed rest



5-Long surgery > 180 minutes





6-Elderly > 65 yearw



7-Smoking



8-ASA class ≥2



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Recommendations of the American College of Physicians to reduce perioperative pulmonary complications in patients undergoing non-cardiothoracic surgery.

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Recommendation 1:

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• All patients undergoing non-cardiothoracic surgery should be evaluated for the presence of the following significant risk factors for postoperative pulmonary complications in order to receive pre- and postoperative interventions to reduce pulmonary risk:

chronic obstructive pulmonary disease, age older than 60 years, American Society of Anesthesiologists class of II or greater, functionally dependent, and congestive heart failure.



• The following are not significant risk factors for postoperative pulmonary complications: obesity and mild or moderate asthma.



Recommendation 2:

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• Patients undergoing the following procedures are at higher risk for postoperative pulmonary complications and should be evaluated for other concomitant risk factors and receive pre- and postoperative interventions to reduce pulmonary complications:

prolonged surgery (>3 hours), abdominal surgery, thoracic surgery, neurosurgery, head and neck surgery, vascular surgery, aortic aneurysm repair, emergency surgery, and general anesthesia.



Recommendation 3:

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• A low serum albumin level (<35 g/L) is a powerful marker of increased risk for postoperative pulmonary complications and should be measured in all patients who are clinically suspected of having hypoalbuminemia; measurement should be considered in patients with one or more risk factors for perioperative pulmonary complications.



Recommendation 4:

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• All patients who after preoperative evaluation are found to be at higher risk for postoperative pulmonary complications should receive the following postoperative procedures in order to reduce postoperative pulmonary complications:

deep breathing exercises or incentive spirometry and the selective use of a nasogastric tube (as needed for postoperative nausea or vomiting, inability to tolerate oral intake, or symptomatic abdominal distention).



Recommendation 5:

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• Preoperative spirometry and chest radiography should not be used routinely for predicting risk for postoperative pulmonary complications.

• Preoperative pulmonary function testing or chest radiography may be appropriate in patients with a previous diagnosis of chronic obstructive pulmonary disease or asthma.



Recommendation 6:

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• The following procedures should not be used solely for reducing postoperative pulmonary complication risk:

right heart catheterization and total parenteral nutrition or total enteral nutrition (for patients who are malnourished or have low serum albumin levels).
الرجوع الى أعلى الصفحة اذهب الى الأسفل
معاينة صفحة البيانات الشخصي للعضو
 
patients at risk Respiratory complications of anaesthesia
استعرض الموضوع السابق استعرض الموضوع التالي الرجوع الى أعلى الصفحة 
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