Artículos de revistas
Prognostic Factors For Complications Following Pulmonary Resection: Pre-albumin Analysis, Time On Mechanical Ventilation, And Other Factors [fatores Prognósticos Em Complicações Pós-operatórias De Ressecção Pulmonar: Análise De Pré-albumina, Tempo De Ventilação Mecânica E Outros]
Registro en:
Jornal Brasileiro De Pneumologia. , v. 32, n. 6, p. 489 - 494, 2006.
18063713
2-s2.0-34247501726
Autor
Bianchi R.C.G.
De Souza J.N.
Giaciani C.D.A.
Hoehr N.F.
Toro I.F.C.
Institución
Resumen
Objective: To determine whether pre-operative nutritional status and post-operative time on mechanical ventilation, as well as others factors, are correlated with post-operative complications (general or pulmonary) in patients undergoing elective thoracic surgery. Methods: A prospective study was conducted, involving 71 patients undergoing elective pulmonary resection. The data collected pre-operatively included gender, age, smoking status, pre-albumin level, lymphocyte count, and body mass index. The peri-operative data included type of surgery and surgical time, as well as post-operative time on mechanical ventilation. Results: Post-operative complications were found to correlate with low pre-albumin concentration, type of resection, surgical time, and post-operative time on mechanical ventilation. Surgical time and post-operative time on mechanical ventilation were also implicated in the post-operative pulmonary complications observed in 22 (30.99%) of the patients studied. Conclusion: Our results suggest that pre-albumin concentration, type of surgery and surgical time, as well as post-operative time on mechanical ventilation, serve as predictive indices of post-operative complications in patients undergoing elective pulmonary resection. In the analysis of the post-operative pulmonary complications, statistically significant correlations were found between such complications and increases in surgical time or post-operative time on mechanical ventilation. 32 6 489 494 Mirra AP, Justo FA. Particularidades da cirurgia pulmonar. In: Jorge Filho I, Andrade JI de, Ziliotto Junior A, editores. Cirurgia geral: pré e pós-operatório. São Paulo: Atheneu 1995. p.605Jackson CV. Preoperative pulmonary evaluation. Arch Intern Med. 1988;148(10):2120-7. Comment in: Arch Intern Med. 1990;150(5):1116Trayner Jr, E., Celli, B.R., Postoperative pulmonary complications (2001) Med Clin North Am, 85 (5), pp. 1129-1139 Jorge Filho I, Basile Filho A, Madureira Filho D. Avaliação nutricional. In: Jorge Filho I, Andrade JI de, Ziliotto Junior A, editores. Cirurgia geral: pré e pósoperatório. São Paulo: Atheneu 1995. p.28-9Bryant, L.R., Morgan Junior, C.V., Parede torácica, pleura, pulmão e mediastino (1985) Princípios de cirurgia, pp. 685-689. , Schwartz SI, editor, 4a ed. Rio de Janeiro: Guanabara Koogan Halbertsma, F.J., Vaneker, M., Scheffer, G.J., van der Hoeven, J.G., Cytokines and biotrauma in ventilator-induced lung injury: A critical review of the literature (2005) Neth J Med, 63 (10), pp. 382-392 Pierson, D.J., Branson, R.D., (1992) Professor's rounds in respiratory care: Prevention of postoperative atelectasis and pneumonia [videoconference], , Irving, Texas: American Association for Respiratory Care November 17 O'Donohue Jr., W.J., Postoperative pulmonary complications. When are preventive and therapeutic measures necessary? (1992) Postgrad Med, 91 (3), pp. 167-170,173-175 Peper, E.A., Conrad, S.A., Respiratory complications of surgery and thoracic trauma (1990) Chest medicine: Essentials of pulmonary and critical care medicine, pp. 453-473. , George R, Light R, Matthay M, Matthay R, editors, Baltimore: Williams & Wilkins; Pesola, G., Nashaa, E., Kvetan, V., Pulmonary complications and respiratory therapy (1990) Postanesthetic care, pp. 63-79. , Frost E, Goldiner P, Bryan-Brown C, editors, Norwalk, Connecticut: Appleton Lange; Schulak, J.A., Complicações cirúrgicas (1996) Fundamentos de cirurgia, pp. 116-118. , Sabiston Junior DC, Lyerly HK, editores, 2a ed. Rio de Janeiro, Guanabara Koogan; Fonseca, J.S., Martins, G.A., (1994) Curso de estatística, , 5a ed. São Paulo: Atlas Hosmer, D.L., Lemeshow, S., (1989) Applied logistic regression, , New York: John Wiley Sons; Boring, C.C., Squires, T.S., Tong, T., Montgomery, S., Cancer statistics, 1994 (1994) CA Cancer J Clin, 44 (1), pp. 7-26 Wang, J., Ultman, R., Olak, J., Prospective trial of diffusing capacity and oxygen consumption in the prediction of pulmonary complications after lung resection (1997) Chest, 112, pp. 153S Garibaldi, R.A., Britt, M.R., Coleman, M.L., Reading, J.C., Pace, N.L., (1981) Risk factors for postoperative pneumonia. Am J Med, 70 (3), pp. 677-680 Bolliger, C.T., Perruchoud, A.P., Functional evaluation of the lung resection candidate (1998) Eur Respir J, 11 (1), pp. 198-212 Berggren, H., Ekroth, R., Malmberg, R., Naucler, J., William-Olsson, G., Hospital mortality and long-term survival in relation to preoperative function in elderly patients with bronchogenic carcinoma (1984) Ann Thorac Surg, 38 (6), pp. 633-636 Damhuis, R.A., Schutte, P.R., Resection rates and postoperative mortality in 7,899 patients with lung cancer (1996) Eur Respir J, 9 (1), pp. 7-10 Nakagawa M, Tanaka H, Tsukuma H, Kishi Y. Relationship between the duration of the preoperative smoke-free period and the incidence of postoperative pulmonary complications after pulmonary surgery. Chest. 2001;120(3): 705-10. Comment in: Chest. 2005;127(6):1873-5Junqueira JC dos S. Fatores de risco nutricionais nas complicações pós-operatórias em pacientes idosos submetidos à cirurgia eletiva de grande porte.[tese]. Campinas: Universidade Estadual de Campinas. 2002Sullivan DH. What do the serum proteins tell us about our elderly patients? J Gerontol A Biol Sci Med Sci. 2001;56(2):M71-4. Comment on: J Gerontol A Biol Sci Med Sci. 2001;56(2):M79-82Measurement of visceral protein status in assessing protein and energy malnutrition: Standard of care. Prealbumin in Nutritional Care Consensus Group (1995) Nutrition, 11 (2), pp. 169-171 Doyle, R.L., Assessing and modifying the risk of postoperative pulmonary complications (1999) Chest, 115 (5 SUPPL.), pp. 77S-81S Pierson, D.J., Complications associated with mechanical ventilation (1990) Crit Care Clin, 6 (3), pp. 711-724 Mayo-Moldes M, Villalain-Perez C, Vicente-Guillen R, Ramos-Briones F, Calvo-Medina V, Morales-Marin P, e t al . [Lung transpl ant at ion for emphy s ema: retrospective study of 65 patients] Med Clin (Barc). 2005;125(16):618-21. Spanish. Comment in: Med Clin (Barc). 2005;125(16):616-7Jiang, S.P., Li, Z.Y., Huang, L.W., Zeng, Z.Y., Chang, J.X., Chen, S., Risk factors for postoperative pulmonary complications after gastroduodenal operation] (2005) Zhonghua Wei Chang Wai Ke Za Zhi, 8 (5), pp. 425-428. , Chinese