Algorithm for the prevention of pulmonary complications after thoracic surgeries
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.
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