Critical care after lung resection: CALoR 1, a single-centre pilot study

Area of Science:

• Thoracic Surgery
• Anesthesiology
• Critical Care Medicine

Background:

• Lung resection surgery carries significant perioperative risks.
• A subset of patients requires intensive care unit (ICU) admission post-operatively.
• Understanding factors influencing ICU admission is crucial for patient management.

Purpose of the Study:

• To characterize patients requiring ICU admission after lung resection.
• To assess the disease burden in this patient group.
• To investigate the impact of anesthetic and surgical techniques on ICU admission rates.

Main Methods:

• Retrospective analysis of 1169 patients undergoing lung resection over two years.
• Logistic regression analysis adjusted for Thoracoscore to identify predictors of ICU admission.
• Comparison of mortality rates between patients admitted to ICU and those not.

Main Results:

• 30 patients (2.6%) required unplanned ICU admission.
• ICU-admitted patients had significantly higher mortality (26.7% vs 0.2%, p < 0.001).
• Open surgical approach (OR 5.25, p=0.025) and volatile anesthesia (OR 2.08, p=0.061) were associated with increased ICU admission likelihood.

Conclusions:

• Open lung resection and volatile anesthesia are potential risk factors for ICU admission.
• This study provides pilot data for a larger multi-center audit by the Association of Cardiothoracic Anaesthetists.
• Further investigation is warranted to optimize anesthetic and surgical strategies for lung resection patients.