Algorithm for the prevention of pulmonary complications after thoracic surgeries

Keywords: thoracic anesthesiology, one lung ventilation, prevention of pulmonary complications.


Annotation. The biggest problem after operations on the thoracic cavity is the number of pulmonary complications (according to various authors 26-38% of cases). Despite the development of numerous methods for the prevention and treatment of these complications, they remain one of the leading causes of hospital mortality and may be an independent risk factor for worse long-term survival. Therefore, the aim of the work was to improve the results of treatment of patients after operations on the thoracic cavity by developing an algorithm for anesthesia for perioperative prevention of pulmonary complications. Participated in the study 192 patients with diseases of the thoracic cavity (esophagus, lungs, mediastinum), operated on in the thoracoabdominal department of the National Institute of Surgery and Transplantology named after O.O. Shalimov. Retrospective comparison group - 96 patients after thoracic surgery, which used conventional methods of perioperative management. The study group consisted of 96 patients after thoracic surgery, who used a perioperative anesthesia algorithm for the prevention of pulmonary complications. Statistical software EZR v. Was used for statistical calculations. 1.54 (graphical user interface for statistical software R version 4.0.3, R Foundation for Statistical Computing, Vienna, Austria). When conducting a multifactor analysis, it was found that the proposed method of prevention of pulmonary complications can reduce (p=0.001) the risk of development, HS=0.27 (95% CI 0.13-0.58) compared with the control group (with standardization by sex, weight, ASA of the patient). Pulmonary complications developed in 33 (34.4%) patients of the control group and in 13 (13.5%) patients of the study group, the difference was statistically significant, p=0.001. Thus, the application of the proposed technique reduces (p = 0.001) the risk of complications, BP=0.39 (95% CI 0.22 - 0.70) compared to traditional methods.


[1] Campos, J. H. (2002). Current techniques for perioperative lung isolation in adults. Anesthesiology, 97(5), 1295-1301. doi: 10.1097/00000542-200211000-00036

[2] Campos, J. H., & Sharma, A. (2019). Predictors of Hypoxemia During One-Lung Ventilation in Thoracic Surgery: Is Oxygen Reserve Index (ORi) the Answer? Journal of Cardiothoracic and Vascular Anesthesia, 34(2), 423-425.

[3] Eldawlatly, A. A., El Tahan, M. R., Kanchi, N. U., Al Qatari, A., & Ahmad, A. E. (2020). Efficacy of height-based formula to predict insertion depth of left-sided double lumen tube: A prospective observational study. Anaesth Intensive Care, 48(5), 354-357. doi: 10.1177/0310057X20946051

[4] Ideris, S. S., Che Hassan M. R., Abdul Rahman, M. R., & Ooi, J. S. (2017). Selection of an appropriate left-sided double-lumen tube size for one-lung ventilation among Asians. Ann Card Anaesth., 20(1), 28–32. doi: 10.4103/0971-9784.197824

[5] Kanda, Y. (2013). Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant., 48(3), 452–458. doi: 10.1038/bmt.2012.244

[6] Kozian, A., & Schilling, T. (2014). Protective Ventilatory Approaches to One-Lung Ventilation: More than Reduction of Tidal Volume. Curr Anesthesiol Rep., 4, 150-159. DOI 10.1007/s40140-014-0057-6

[7] Slinger, P. (2001). Lung isolation in thoracic anesthesia, state of the art. Can J Anaesth., 48(1), R13–R15. doi: 10.1007/BF03028172

[8] Slinger, P. (2003). A view of and through double lumen tubes. J Cardiothorac Vasc Anesth., 17(3), 287–288. doi: 10.1016/s1053-0770(03)00058-2

[9] Wu, Y., Yang, R., Xu, J., Rusidanmu, A., Zhang, X., & Hu, J. (2019). Effects of Intraoperative Fluid Management on Postoperative Outcomes After Lobectomy. Ann Thorac Surg., 107(6), 1663-1669. doi: 10.1016/j.athoracsur.2018.12.013

[10] Zhang C, Qin X, Zhou W, He, S., Liu, A., Zhang, Y., … & Yin, J. (2021). Prediction of left double-lumen tube size by measurement of cricoid cartilage transverse diameter by ultrasound and CT multi-planar reconstruction. Front Med (Lausanne), 8, 657612. doi: 10.3389/fmed.2021.657612
How to Cite
Usenko, O. Y., Sydiuk, A. V., Sydiuk, O. E., Klimas, A. S., Savenko, G. Y., & Teslya, O. T. (2021). Algorithm for the prevention of pulmonary complications after thoracic surgeries. Reports of Vinnytsia National Medical University, 25(3), 462-465.