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Risk Factors Associated With Early Postoperative Respiratory Failure: A Matched Case-Control Study
Jacqueline C Stocking1, Christiana Drake2, J Matthew Aldrich3
1Department of Internal Medicine, University of California Davis, Sacramento, California.
The Journal of Surgical Research
|January 23, 2021
Summary
Modifiable factors like intraoperative ventilator settings and fluid balance are linked to early postoperative respiratory failure. These findings may help reduce the incidence of this common pulmonary complication after surgery.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Pulmonary Medicine
Background:
- Postoperative respiratory failure is a significant complication following surgery.
- Factors influencing its early development remain incompletely understood.
- Identifying modifiable risk factors is crucial for prevention.
Purpose of the Study:
- To identify modifiable factors associated with early postoperative respiratory failure.
- To investigate risk factors developing within the first 5 days after elective operations.
Main Methods:
- Matched case-control study.
- Involved 638 adult patients across five academic medical centers.
- Matched cases and controls based on hospital, age, and surgical procedure.
Main Results:
- Male gender, higher American Society of Anesthesiologists class, and increased comorbidities were associated with increased risk.
- Longer operative duration, higher intraoperative positive end-expiratory pressure (PEEP) and tidal volume, and greater 24-hour net fluid balance were significant risk factors.
Conclusions:
- Increased intraoperative ventilator volume and pressure, along with 24-hour fluid balance, are potentially modifiable factors.
- Further research is needed to verify these risk factors and evaluate targeted interventions.
- These findings may inform strategies to reduce early postoperative respiratory failure.
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