Perioperative risk analysis for acute respiratory distress syndrome after elective oesophagectomy.
ANZ J Surg
; 81(10): 700-6, 2011 Oct.
Article
em En
| MEDLINE
| ID: mdl-22295310
ABSTRACT
BACKGROUND:
Acute respiratory distress syndrome (ARDS) is a major contributor to respiratory morbidity and mortality after oesophagectomy. Several pre-, intra- and post-operative factors are thought to predispose to its development in the post-oesophagectomy period. The aim of this study was to determine factors predisposing to ARDS in the post-oesophagectomy period.METHODS:
A total of 112 patients who underwent elective oesophagectomy for oesophageal cancer (gastro-oesophageal adenocarcinoma and high-grade dysplasia, 93; oesophageal squamous cell carcinoma, 16; oesophageal oat cell tumour, 1; oesophageal anaplastic carcinoma, 1; oesophageal colloid carcinoma, 1) between 1 January 2003 and 31 December 2006 formed the study group in this retrospective study. The pre-, intra and post-operative data for these patients (male female = 8923, mean age 60.8 years) were collected from an oesophagectomy database and hospital medical records.RESULTS:
The incidence of ARDS was 13%. The in-hospital mortality among ARDS cases was 20% and 1-year mortality was 40%. Various factors such as preoperative chronic respiratory disease (P-value = 0.000, odds ratio = 17.76), smoking pack-years (P-value = 0.045, odds ratio = 1.02), abnormal preoperative forced expiratory volume in 1 s (P-value = 0.009, odds ratio = 7.97), high percentage of oxygen in inspired air (P-value = 0.041, odds ratio = 1.24) and use of perioperative inotropes (P-value = 0.021, odds ratio = 4.26) were associated with ARDS.CONCLUSIONS:
Preoperative physiological status as indicated by a preoperative history of chronic respiratory disease and preoperative pulmonary function influenced the post-operative outcome in our patients. The use of perioperative inotropes suggests perioperative cardiorespiratory instability, and could also predispose to the development of ARDS in the post-operative period.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome do Desconforto Respiratório
/
Neoplasias Esofágicas
/
Esofagectomia
/
Procedimentos Cirúrgicos Eletivos
/
Medição de Risco
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Oceania
Idioma:
En
Revista:
ANZ J Surg
Ano de publicação:
2011
Tipo de documento:
Article