Daniela Damian1, Jacob Esquenazi2, Umamaheswar Duvvuri3, Jonas T Johnson4, Tetsuro Sakai5. 1. Assistant Professor, Department of Anesthesiology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: damiand@upmc.edu. 2. Resident Physician, Department of Anesthesiology, Albert Einstein College of Medicine, New York, NY, USA. Electronic address: jesquena@montefiore.org. 3. Assistant Professor, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: duvvuriu@upmc.edu. 4. Professor and Chairman, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: johnsonjt@upmc.edu. 5. Professor, Department of Anesthesiology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: sakait@upmc.edu.
Abstract
STUDY OBJECTIVE: Postoperative pulmonary complications (PPCs) are significant problems in patients undergoing radical head and neck cancer surgery with free flap reconstruction. The objective of the study was to identify the incidence, outcome, and risk factors for PPCs We hypothesized that preoperative pulmonary disease and amount of fluid administered during the surgery would be associated with PPCs. DESIGN: A retrospective clinical observational study. SETTING: A large academic institution. SUBJECTS: A total of 110 patients who underwent head and neck cancer surgery with microvascular free flap reconstruction between January 1, 2005 and December 31, 2011. INTERVENTIONS: No study interventions were performed. MEASUREMENTS: PPCs including pulmonary edema, pneumonia, and acute respiratory distress syndrome were clinically diagnosed. Perioperative parameters and outcomes among patients with and without PPCs were compared. Factors predictive of PPCs were identified with univariate and multiple logistic regression analyses. MAIN RESULTS: The incidence of PPCs was 32.7% (36 patients): pulmonary edema in 23.6% (26) and pneumonia in 9.1% (10). No acute respiratory distress syndrome was found. Inhospital mortality was 1.8% (2). No difference was found in survival between the patients with PPCs and those without (1 year survival was 69.4% vs 78.4%; P=.85). The patients with PPCs required longer ventilation support (median, 4 vs 2days; P=.002) and more frequent intensive care unit readmissions (30.3% vs 5.7%; P=.001) and stayed longer in the hospital (median, 17 vs 12days; P=.014). None of the preoperative parameters or intraoperative parameters including pulmonary comorbidity or the amounts of intraoperative fluid/blood administration was found as the factor to predict postoperative pulmonary compilations. CONCLUSION: The incidence of PPCs in patients undergoing radical head and neck surgery was 32.7% in 110 patients. Preoperative pulmonary disease or the amount of fluid administered during the surgery was not associated with PPCs.
STUDY OBJECTIVE:Postoperative pulmonary complications (PPCs) are significant problems in patients undergoing radical head and neck cancer surgery with free flap reconstruction. The objective of the study was to identify the incidence, outcome, and risk factors for PPCs We hypothesized that preoperative pulmonary disease and amount of fluid administered during the surgery would be associated with PPCs. DESIGN: A retrospective clinical observational study. SETTING: A large academic institution. SUBJECTS: A total of 110 patients who underwent head and neck cancer surgery with microvascular free flap reconstruction between January 1, 2005 and December 31, 2011. INTERVENTIONS: No study interventions were performed. MEASUREMENTS: PPCs including pulmonary edema, pneumonia, and acute respiratory distress syndrome were clinically diagnosed. Perioperative parameters and outcomes among patients with and without PPCs were compared. Factors predictive of PPCs were identified with univariate and multiple logistic regression analyses. MAIN RESULTS: The incidence of PPCs was 32.7% (36 patients): pulmonary edema in 23.6% (26) and pneumonia in 9.1% (10). No acute respiratory distress syndrome was found. Inhospital mortality was 1.8% (2). No difference was found in survival between the patients with PPCs and those without (1 year survival was 69.4% vs 78.4%; P=.85). The patients with PPCs required longer ventilation support (median, 4 vs 2days; P=.002) and more frequent intensive care unit readmissions (30.3% vs 5.7%; P=.001) and stayed longer in the hospital (median, 17 vs 12days; P=.014). None of the preoperative parameters or intraoperative parameters including pulmonary comorbidity or the amounts of intraoperative fluid/blood administration was found as the factor to predict postoperative pulmonary compilations. CONCLUSION: The incidence of PPCs in patients undergoing radical head and neck surgery was 32.7% in 110 patients. Preoperative pulmonary disease or the amount of fluid administered during the surgery was not associated with PPCs.
Authors: Bryan J Dooley; Daniella Karassawa Zanoni; Marlena R Mcgill; Mahmoud I Awad; Jatin P Shah; Richard J Wong; Clara Broad; Babak J Mehrara; Ian Ganly; Snehal G Patel Journal: Head Neck Date: 2019-10-08 Impact factor: 3.147
Authors: Derek K Smith; Robert E Freundlich; Justin R Shinn; C Burton Wood; Sarah L Rohde; Matthew D McEvoy Journal: Head Neck Date: 2021-03-30 Impact factor: 3.821
Authors: Morad Chughtai; Chukwuweike U Gwam; Nequesha Mohamed; Anton Khlopas; Jared M Newman; Rafay Khan; Ali Nadhim; Shervin Shaffiy; Michael A Mont Journal: J Clin Med Res Date: 2017-04-26