Englewood Hospital and Medical Center, Englewood, NJ, USA.
Crit Care Med. 2011 Sep;39(9):2163-72. doi: 10.1097/CCM.0b013e31821f0522.
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.
We conducted PubMed searches for relevant literature on postoperative pulmonary complications in addition to using the summit participants' experience in the management of patients with postoperative pulmonary complications.
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.
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.
术后肺部并发症是手术总体风险的主要因素。我们召开了一次患者安全峰会，以讨论提高医生对术后肺部并发症的认识，将术后肺部并发症作为一个实质性的公共卫生问题提出来，需要国家关注，建议减少术后肺部并发症对临床结果和医疗成本的不利影响的策略，并建立一个算法，以帮助识别术后肺部并发症风险增加的患者。
我们进行了术后肺部并发症相关文献的 PubMed 检索，同时还利用峰会参与者在管理术后肺部并发症患者方面的经验。
术后肺部并发症很常见，与发病率和死亡率增加有关，并对医疗保健的财务结果产生不利影响。需要采取多方面的方法来降低术后肺部并发症的发生率。确定可衡量的风险标志物将有助于有针对性地实施降低风险的策略。
最实用的可以识别术后肺部并发症风险最高的患者的标志物是术后机械通气累计时间>48 小时的需求。
