Degani-Costa Luiza Helena, Faresin Sonia Maria, dos Reis Falcão Luiz Fernando
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil; Massachusetts General Hospital, Harvard Medical School, MA, USA.
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Braz J Anesthesiol. 2014 Jan-Feb;64(1):22-34. doi: 10.1016/j.bjane.2012.11.002. Epub 2013 Dec 17.
In daily clinical practice, pulmonary complications related to surgical procedure are common, increasing the morbidity and mortality of patients. Assessment of the risk of pulmonary complications is an important step in the preoperative evaluation. Thus, we review the most relevant aspects of preoperative assessment of the patient with lung disease.
Pulmonary risk stratification depends on clinical symptoms and patient's physical status. Age, preexisting respiratory diseases, nutritional status, and continued medical treatment are usually more important than additional tests. Pulmonary function tests are of great relevance when high abdominal or thoracic procedures are scheduled, particularly when lung resection are considered.
Understanding the perioperative evaluation of the potential risk for developing pulmonary complication allows the medical team to choose the adequate anesthetic technique and surgical and clinical care required by each patient, thereby reducing adverse respiratory outcomes.
在日常临床实践中,与手术相关的肺部并发症很常见,会增加患者的发病率和死亡率。评估肺部并发症风险是术前评估的重要一步。因此,我们回顾了肺部疾病患者术前评估的最相关方面。
肺部风险分层取决于临床症状和患者的身体状况。年龄、既往呼吸系统疾病、营养状况和持续的药物治疗通常比其他检查更为重要。当计划进行高腹部或胸部手术时,尤其是考虑肺切除时,肺功能测试具有重要意义。
了解围手术期发生肺部并发症的潜在风险评估,有助于医疗团队为每位患者选择合适的麻醉技术以及所需的手术和临床护理,从而减少不良呼吸结局。