The document discusses postoperative care and chest complications. It covers several key points:
1) Respiratory complications occur in up to 15% of major surgeries and can negatively impact outcomes through increased mortality, morbidity, hospitalization duration, and costs.
2) Patients face respiratory risks in the immediate postoperative period from issues like atelectasis, pulmonary edema, and respiratory failure due to changes in lung volumes and function.
3) Preventing postoperative pulmonary complications requires evaluating patient risk factors, optimizing pre- and postoperative pulmonary status through measures like smoking cessation, treating infections, and encouraging deep breathing exercises.
Gupta indices for postop pulmonary complicationsTerry Shaneyfelt
Gupta and colleagues developed 2 prediction rules that can be used to estimate a patient's risk for postoperative pneumonia or respiratory failure. I also review an older prediction rule and show how it compares to the Gupta rules.
Gupta indices for postop pulmonary complicationsTerry Shaneyfelt
Gupta and colleagues developed 2 prediction rules that can be used to estimate a patient's risk for postoperative pneumonia or respiratory failure. I also review an older prediction rule and show how it compares to the Gupta rules.
The presentation deals with the basics of pre anesthetic checkups, its only for the educations purpose!
Any kind of replication, modifications and republication is strictly prohibited.
All Rights reserved to the Author. 2016
anesthesia is a vast area for study . to make it simple for paramedics some important rules of anesthesia are explained in the most simplest way. rules of anesthesia can very as per the type of anesthesia.
Mvss part v weaning & liberation from mechanical ventilationSanti Silairatana
Slides accompanying the Lecture/Review Mechanical Ventilatory support series part V/V: Weaning and liberation from mechanical ventilatory support. For medical students and residents in Internal medicine. Contents are including rationale of weaning, predictors of weaning success and failure, methods of weaning, and detection and management of weaning failure
anaesthesia for lung transplant. indication and contra indication for lung transplant. intra-op and post op complications of lung transplant,
post op pain relief for lung transplant. patient selection for lung transplant. donor criteria for lung donor
The presentation deals with the basics of pre anesthetic checkups, its only for the educations purpose!
Any kind of replication, modifications and republication is strictly prohibited.
All Rights reserved to the Author. 2016
anesthesia is a vast area for study . to make it simple for paramedics some important rules of anesthesia are explained in the most simplest way. rules of anesthesia can very as per the type of anesthesia.
Mvss part v weaning & liberation from mechanical ventilationSanti Silairatana
Slides accompanying the Lecture/Review Mechanical Ventilatory support series part V/V: Weaning and liberation from mechanical ventilatory support. For medical students and residents in Internal medicine. Contents are including rationale of weaning, predictors of weaning success and failure, methods of weaning, and detection and management of weaning failure
anaesthesia for lung transplant. indication and contra indication for lung transplant. intra-op and post op complications of lung transplant,
post op pain relief for lung transplant. patient selection for lung transplant. donor criteria for lung donor
Complications in the first 48hrs after oral &/ dental implant coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
A very large proportion of Intensive Care Patients. Discussed in detail about causes diagnosis and management pearls of neuromuscular respiratory failure. Intensive Care Physicians will find this presentation very useful and informative.
Complications of anesthesia
This topic aim to provide information on some common clinical condition that occur to the patients after anesthetized required procedure
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
3. Learning Objectives
• Accept that complications are best anticipated
and avoided.
• Recognize the incidence of co-morbidity.
• Understand the importance of matching the
procedure to the associated risks.
• Appreciate the importance of recognizing
complications early and treating them
vigorously.
• Enumerate the risk factors- Patient vs procedure
related
• Enlist Prediction tools and their efficiency
• Outline available guidelines
• Enlist preventive measures
4. The Importance of Pulmonary Complications
Adversely affects mortality and morbidity
Increases the duration of hospitalization
Increases the need for intensive care
Increases the cost
Sweitzer BJ, Anesthesiology Clin 27 (2009); 673 – 86
6. Factors related to PPCs
• Patients-related risk factors
• Risk factors related to preoperative care
• Operation-related risk factors
• Anesthetic-related risk factors
• Risk factors related to postoperative care
7. PHASES
• IMMEDIATE ( POST-ANAESTHETIC ) PHASE (1)
• INTERMEDIATE ( HOSPITAL STAY ) PHASE (2)
• CONVALESCENT ( AFTER DISCHARGE TO FULL RECOVERY )
8. AIM OF PHASES 1 & 2
• HOMEOSTASIS
• TREATMENT OF PAIN
• PREVENTION & EARLY DETECTION OF
COMPLICATIONS
12. Pathophysiology
• Functional residual capacity ( FRC) and vital capacity (VC)
decrease after major intra-abdominal surgery down to 40% of
the Pre-Op. Level.
• These go up slowly to 60-70% by 6th -7th day and to normal
Pre-Op. Level after that.
• FRC, VC, and Post-Op. pulmonary oedema (Post anaesthesia)
Contribute to the changes in pulmonary functions Post-Op.
• The above changes are accentuated by obesity, heavy
smoking or Pre-existing lung diseases specially in elderly.
13. • Post-Op. atelectasis is enhanced by shallow
breathing, pain, obesity and abdominal distension
(restriction of diaphragmatic movements)
• Post-Op. physiotherapy especially deep inspiration
helps to decrease atelectasis. Also O2 mask and
periodic hyperinflation using spirometer.
• Early mobilization helps a lot.
• Antibiotics and treatment of heart failure Post-Op. by
adequate management of fluids will help reduce
pulmonary oedema.
14. Respiratory pathophysiology during/after surgery
Postoperative pain
& Muscle splinting
Diaphragmatic
dysfunction due to CNS
output to phrenic nerves
Changes in lung volumes
Restrictive lung function
FRC Hypoxia
Airway closure
Atelectasis
15. Respiratory pathophysiology during/after surgery
Changes in control of breathing
Residual effects of
anesthetics
Narcotics for
analgesics
Respiratory depression
Difficulty
weaning
Hypoxia
Hypercapnia
Deep breaths
Atelectasis
16. Respiratory pathophysiology during/after surgery
Impaired lung defence
Pain
Excessive use of
analgesics
Damage to cilia
Presence of ETT
Anesthetic gases
Cough
Mucociliary clearance
AtelectasisSecretions
ColonisationInfections
17. Respiratory pathophysiology during/after surgery
Bronchoconstriction
Aspiration of gastric
contents
Exacerbation of underlying
asthma or COPD
Endotracheal intubation
or surgical stimulation
Histamine release
secondary medication
Bronchospasm
18. Independent Risk Factors
for Pulmonary Complications
• Age over 60
• History of COPD
• History of CHF
• Functional Dependence
• Tobacco cessation within past 8 weeks?
• ASA Class II or greater
• Serum Albumin < 3.5
19. ASA (American Society of Anesthesiology)
Score
1 A normal healthy person
2 Mild systemic disease
3 Systemic disease that is not incapacitating.
4 Incapacitating systemic disease that is
a threat to life
5 Moribund, not expected to survive 24 hours
with or without operation.
20. Factors associated with a
Moderate Increase in Risk
• Chronic Tobacco or Alcohol Use
• Altered Mental Status
• Weight Loss (>10% in last 6 months)
• History of CVA/stroke
• Clinical Chest Findings/Abnormal CXR
• BUN > 21
• Perioperative Transfusion
• Preoperative stay >4 days
21. No independent Risk of
Pulmonary Complications
• Obesity
• Controlled Asthma
• Diabetes Mellitus
• Obstructive Sleep
Apnea
• Chronic Steroid Use
• HIV Infection
• History of Cardiac
Arrythmias
• Poor Exercise Tolerance
• Abnormal Pre-Op
Spirometry
22. Procedure-related Risk
• Procedures lasting > 3 hours
• Emergency Surgery
• Aortic/Vascular Surgery
• Thoracic or Upper Abdominal Surgery
• Neurosurgery
• Neck Surgery
• General Anesthesia
• Use of Long-acting NM blockade
• Duration of anaesthesia
• Nasogastric intubation
• Type of surgery
23. Procedures not associated with increased
risk
• Esophageal Surgery
• Gynecologic Surgery
• Urologic Surgery
• Hip Fracture Repair
• Open vs. Laparascopic Procedures
31. Postoperative Pulmonary Complications
A. Atelectasis:
– 90% postoperative pulmonary complications
Etiology:
1. Obstruction of the tracheobronchial airway
a) Changes in bronchial secretions
b) Defects in expulsion mechanism
c) Reduction in bronchial caliber
2. Pulmonary insufficiency (hypoventilation)
– Decrease surfactant
35. Postoperative Pulmonary Complications
A. Atelectasis:
Treatment:
1. Preop prophylaxis:
a. No smoking (2 wks)
b. Treatment of pulmonary problem
2. Postop prophylaxis:
− Minimal use of depressant drugs
− Prevent pain
− Early ambulation
− Changes body position
− Deep breathing and coughing exercises
3. Drugs:
a. Expectorants
b. Mucolytic
c. bronchodilators
36. Postoperative Pulmonary Complications
B. Pulmonary Aspiration:
– General anesthesia – pts are in supine
position and absence of normal protective
reflexes.
– Increased risk:
1. Pregnant
2. Elderly
3. Obese
4. Pts w/ bowel obstruction
37. Postoperative Pulmonary Complications
B. Pulmonary Aspiration:
Prevention:
• NPO 6hrs prior to surgery
• Emergency – NGT do gastric lavage and give
antacid to prevent dev. of Mendelian’s Syndrome.
Treatment:
• Continuous mechanical ventilation
• antibiotics
38. Postoperative Pulmonary Complications
C. Pulmonary Edema:
Etiology:
1. Circulatory overload (infusion of fluid during
operation)
Most common cause
2. Left ventricular failure (incomplete cardiac
emptying)
Due to anesthetic, narcotic or hypnotic agents w/c
decrease myocardial contractility
Decrease peripheral perfusion -----> peripheral
vasoconstriction ----> cause blood to shift centrally -
---> pulmonary edema
3. Negative pressure in airway.
39. Postoperative Pulmonary Complications
C. Pulmonary Edema:
Treatment:
1. Provide oxygen (increase inspired concentration)
2. Remove obstructing fluid (diuretics, head up or
sitting position, phlebotomy, spinal anesthesia,
ganglionic blocking agents)
3. Correcting the circulatory overload
4. Increase airway pressure (PEEP)
40. Postoperative Pulmonary Complications
D. Respiratory Failure:
– 25% of postoperative deaths
– Tachypnea > 25-30/min
– Low tidal volume < 4ml /kg
– High Pco2 > 45mmHg while the patient is
breathing room air
– Low Po2 < 60mmHg in the absence of metabolic
alkalosis
– Usually seen in patients who underwent
operations for major trauma or who have
multisystem disease.
– Mechanism is unknown
41. Postoperative Pulmonary Complications
D. Respiratory Failure:
Etiologic Factors:
1. Sepsis
2. Massive transfusion
3. Fat embolism
4. Pancreatitis
5. Aspiration
– Associated w/ a decreased Functional Residual Lung
Capacity, indicating that the amount of air w/ in the lung at the
end of normal expiration is reduced ----> diminished ventilation-
perfusion ratio and ultimately arterial hypoxemia
Treatment:
• Mechanical ventilation (PEEP)
42. Pulmoary embolism
• A very serious complication of DVT
• 10% die within the first hour
• 90% live longer than one hour-of these
patients 70 percent go undiagnosed and of
these 30 % die
47. The evaluation of patient
• Clinical Evaluation (History - Physical Examination)
• Laboratory Evaluation
Functional evaluation (PFT)
Arterial Blood Gases
Chest X-ray
ECG
• General Condition Assessment
Classification of ASA (American Society of Anesthesiologists)
Cardiopulmonary Risk Index
48. PREVENTION
• RECOVERY ROOM :
ANAESTHETIST RESPONSIBILITIES TOWARDS CARDIO-
PULMONARY FUNCTIONS.
SURGEON’S RESPONSIBILITIES TOWARDS THE OPERATION
SITE.
• TRAINED NURSING STAFF :
T0 HANDLE INSTRUCTIONS.
• CONTINUOUS MONITORING OF PATIENT (VITAL
SIGNS etc.)
49. Post-Op recommendations to
reduce Pulmonary Complications
• Deep Breathing Exercises/Incentive
Spirometry
• CPAP – if patient cannot cooperate for I.S.
• Avoid routine use of NG tubes
• Adequate Pain Control
50. Smoking cessation for ≥8 weeks
Treatment for patients with underlying asthma / COPD (PFT)
Delay elective surgery and treat with antibiotics if respiratory
infection is present
Patient education regarding lung expansion maneuvers
Obese patients should be managed to lose weight
Choose procedure lasting < 4 hrs (if possible)
Minimize duration of anesthesia
Avoid use of long-acting neuroblockers (ie pancuronium) in high risk
patients
Prevention of Risks