1. Lung Ultrasound Findings in the Postanesthesia Care Unit Are Associated With Outcome After Major Surgery: A Prospective Observational Study in a High-Risk Cohort
- Author
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Gary Duclos, Mickael Papinko, Emmanuel Futier, Pascal Thomas, Laurent Zieleskiewicz, Alain Boussuges, Alice Baldovini, Stéphane Berdah, Zoe Meresse, David Fiocchi, Noémie Resseguier, Alexandre Lopez, Belaid Bouhemad, Marc Leone, Ben Creagh-Brown, and François Antonini
- Subjects
Lung Diseases ,Male ,medicine.medical_specialty ,Pleural effusion ,medicine.medical_treatment ,Cohort Studies ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,030202 anesthesiology ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Lung ,Aged ,Postoperative Care ,Mechanical ventilation ,business.industry ,Mortality rate ,Odds ratio ,Middle Aged ,Thoracic Surgical Procedures ,medicine.disease ,Confidence interval ,3. Good health ,Surgery ,Treatment Outcome ,Anesthesiology and Pain Medicine ,Cohort ,Female ,business ,Cohort study - Abstract
BACKGROUND Postoperative pulmonary complications are associated with increased morbidity. Identifying patients at higher risk for such complications may allow preemptive treatment. METHODS Patients with an American Society of Anesthesiologists (ASA) score >1 and who were scheduled for major surgery of >2 hours were enrolled in a single-center prospective study. After extubation, lung ultrasound was performed after a median time of 60 minutes by 2 certified anesthesiologists in the postanesthesia care unit after a standardized tracheal extubation. Postoperative pulmonary complications occurring within 8 postoperative days were recorded. The association between lung ultrasound findings and postoperative pulmonary complications was analyzed using logistic regression models. RESULTS Among the 327 patients included, 69 (19%) developed postoperative pulmonary complications. The lung ultrasound score was higher in the patients who developed postoperative pulmonary complications (12 [7-18] vs 8 [4-12]; P < .001). The odds ratio for pulmonary complications in patients who had a pleural effusion detected by lung ultrasound was 3.7 (95% confidence interval, 1.2-11.7). The hospital death rate was also higher in patients with pleural effusions (22% vs 1.3%; P < .001). Patients with pulmonary consolidations on lung ultrasound had a higher risk of postoperative mechanical ventilation (17% vs 5.1%; P = .001). In all patients, the area under the curve for predicting postoperative pulmonary complications was 0.64 (95% confidence interval, 0.57-0.71). CONCLUSIONS When lung ultrasound is performed precociously
- Published
- 2020
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