切换至 "中华医学电子期刊资源库"

中华临床医师杂志(电子版) ›› 2023, Vol. 17 ›› Issue (01) : 7 -22. doi: 10.3877/cma.j.issn.1674-0785.2023.01.002

所属专题: 指南共识

专家共识

老年患者术后肺部并发症防治专家共识
中国老年医学学会麻醉学分会   
  1. 1. 解放军总医院第一医学中心麻醉科,北京 100853
    2. 山东第一医科大学第一附属医院(千佛山医院)麻醉与围术期医学科,济南 250014
  • 收稿日期:2022-12-09 出版日期:2023-01-15
  • 基金资助:
    国家重点研发计划(2018YFC2001900)

Expert consensus on prevention and treatment of postoperative pulmonary complications in elderly patients

Chinese Geriatrics Society Anesthesia Branch   

  1. 1. Department of Anesthesiology, First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
    2. Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan 250014, China
  • Received:2022-12-09 Published:2023-01-15
引用本文:

中国老年医学学会麻醉学分会. 老年患者术后肺部并发症防治专家共识[J]. 中华临床医师杂志(电子版), 2023, 17(01): 7-22.

Chinese Geriatrics Society Anesthesia Branch. Expert consensus on prevention and treatment of postoperative pulmonary complications in elderly patients[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(01): 7-22.

术后肺部并发症(PPCs)是影响老年患者术后转归的主要因素之一,重视并积极地预防和处理PPCs,对降低老年患者围术期风险、改善预后具有重要意义。本共识将从术前准备、术中管理、术后管理、围术期呼吸功能监测以及特殊患者的管理,系统阐述PPCs的防治策略并做出相关推荐。

Postoperative pulmonary complications (PPCs) are one of the main factors affecting the postoperative outcome of elderly patients. In order to reduce the perioperative risk and improve the prognosis of elderly patients, attention should be paid to the prevention and treatment of PPCs. This expert consensus will systematically expound the prevention and treatment strategies for PPCs and make relevant recommendations, including preoperative preparation, intraoperative management, postoperative management, perioperative respiratory function monitoring, and management of special patients.

表1 本共识采用的临床推荐分级与循证证据等级
附表1 营养不良诊断标准共识的全球权威倡议(GLIM)营养不良严重程度分级标准
附表2 改良衰弱指数(mFI)评分
附表3 加泰罗尼亚外科患者呼吸风险评估表(ARISCAT)
1
中华人民共和国国家卫生健康委员会. 2020年度国家老龄事业发展公报[EB/OL]. 国家卫生健康委员会, 北京, 2021. (2022-10-09).

URL    
2
Lawrence VA, Hilsenbeck SG, Mulrow CD, et al. Incidence and hospital stay for cardiac and pulmonary complications after abdominal surgery [J]. J Gen Intern Med, 1995, 10(12): 671-678.
3
Jammer I, Wickboldt N, Sander M, et al. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures [J]. Eur J Anaesthesiol, 2015, 32(2): 88-105.
4
Serpa Neto A, Hemmes SN, Barbas CS, et al. Incidence of mortality and morbidity related to postoperative lung injury in patients who have undergone abdominal or thoracic surgery: a systematic review and meta-analysis [J]. Lancet Respir Med, 2014, 2(12): 1007-1015.
5
Sin D. Postoperative pulmonary complications: what every general practitioner ought to know [J]. BC Med J, 2008, 50(3): 152-154.
6
曲宗阳, 周淑珍, 包杰, 等. 老年腹部大手术患者术后肺部并发症及相关因素分析 [J]. 中华老年医学杂志, 2020, 39(9): 1034-1037.
7
Jin Y, Xie G, Wang H, et al. Incidence and risk factors of postoperative pulmonary complications in noncardiac Chinese patients: a multicenter observational study in university hospitals [J]. Biomed Res Int, 2015, 2015: 265165.
8
Miskovic A, Lumb AB. Postoperative pulmonary complications [J]. Br J Anaesth, 2017, 118(3): 317-334.
9
Canet J, Gallart L, Gomar C, et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort [J]. Anesthesiology, 2010, 113(6): 1338-1350.
10
Brooks-Brunn JA. Predictors of postoperative pulmonary complications following abdominal surgery [J]. Chest, 1997, 111(3): 564-571.
11
Yang CK, Teng A, Lee DY, et al. Pulmonary complications after major abdominal surgery: National Surgical Quality Improvement Program analysis [J]. J Surg Res, 2015, 198(2): 441-449.
12
Ramachandran SK, Nafiu OO, Ghaferi A, et al. Independent predictors and outcomes of unanticipated early postoperative tracheal intubation after nonemergent, noncardiac surgery [J]. Anesthesiology, 2011, 115(1): 44-53.
13
Kor DJ, Warner DO, Alsara A, et al. Derivation and diagnostic accuracy of the surgical lung injury prediction model [J]. Anesthesiology, 2011, 115(1): 117-128.
14
Blum JM, Stentz MJ, Dechert R, et al. Preoperative and intraoperative predictors of postoperative acute respiratory distress syndrome in a general surgical population [J]. Anesthesiology, 2013, 118(1): 19-29.
15
McAlister FA, Bertsch K, Man J, et al. Incidence of and risk factors for pulmonary complications after nonthoracic surgery [J]. Am J Respir Crit Care Med, 2005, 171(5): 514-517.
16
Arozullah AM, Khuri SF, Henderson WG, et al. Development and validation of a multifactorial risk index for predicting postoperative pneumonia after major noncardiac surgery [J]. Ann Intern Med, 2001, 135(10): 847-857.
17
Johnson RG, Arozullah AM, Neumayer L, et al. Multivariable predictors of postoperative respiratory failure after general and vascular surgery: results from the patient safety in surgery study [J]. J Am Coll Surg, 2007, 204(6): 1188-1198.
18
Kaw R, Chung F, Pasupuleti V, et al. Meta-analysis of the association between obstructive sleep apnoea and postoperative outcome [J]. Br J Anaesth, 2012, 109(6): 897-906.
19
Smetana GW, Lawrence VA, Cornell JE, et al. Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians [J]. Ann Intern Med, 2006, 144(8): 581-595.
20
Mazo V, Sabaté S, Canet J, et al. Prospective external validation of a predictive score for postoperative pulmonary complications [J]. Anesthesiology, 2014, 121(2): 219-231.
21
Li C, Yang WH, Zhou J, et al. Risk factors for predicting postoperative complications after open infrarenal abdominal aortic aneurysm repair: results from a single vascular center in China [J]. J Clin Anesth, 2013, 25(5): 371-378.
22
Slutsky AS, Ranieri VM. Ventilator-induced lung injury [J]. N Engl J Med, 2013, 369(22): 2126-2136.
23
王天佑. 胸外科围手术期肺部并发症防治专家共识 [J]. 中华胸心血管外科杂志, 2009, 25(4): 217-218.
24
Lee H, Kim HK, Kang D, et al. Prognostic value of 6-min walk test to predict postoperative cardiopulmonary complications in patients with non-small cell lung cancer [J]. Chest, 2020, 157(6): 1665-1673.
25
Okazaki T, Ebihara S, Mori T, et al. Association between sarcopenia and pneumonia in older people [J]. Geriatr Gerontol Int, 2020, 20(1): 7-13.
26
Kruk ME, Gage AD, Arsenault C, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution [J]. Lancet Glob Health, 2018, 6(11): e1196-e1252.
27
Cederholm T, Jensen GL, Correia M, et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community [J]. Clin Nutr, 2019, 38(1): 1-9.
28
Kakavas S, Karayiannis D, Bouloubasi Z, et al. Global leadership initiative on malnutrition criteria predict pulmonary complications and 90-day mortality after major abdominal surgery in cancer patients [J]. Nutrients, 2020, 12(12): 3726.
29
Morley JE, Vellas B, van Kan GA, et al. Frailty consensus: a call to action [J]. J Am Med Dir Assoc, 2013, 14(6): 392-397.
30
Buitrago DH, Gangadharan SP, Majid A, et al. Frailty characteristics predict respiratory failure in patients undergoing tracheobronchoplasty [J]. Ann Thorac Surg, 2018, 106(3): 836-841.
31
Salim TI, Nestlerode LC, Lucatorto EL, et al. Frailty as tested by gait speed is a risk factor for liver transplant respiratory complications [J]. Am J Gastroenterol, 2020, 115(6): 859-866.
32
Velanovich V, Antoine H, Swartz A, et al. Accumulating deficits model of frailty and postoperative mortality and morbidity: its application to a national database [J]. J Surg Res, 2013, 183(1): 104-110.
33
Aceto P, Perilli V, Luca E, et al. Predictive power of modified frailty index score for pulmonary complications after major abdominal surgery in the elderly: a single centre prospective cohort study [J]. Eur Rev Med Pharmacol Sci, 2021, 25(10): 3798-3802.
34
Maddocks M, Kon SS, Canavan JL, et al. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study [J]. Thorax, 2016, 71(11): 988-995.
35
Simon P, Girrbach F, Petroff D, et al. Individualized versus fixed positive end-expiratory pressure for intraoperative mechanical ventilation in obese patients: a secondary analysis [J]. Anesthesiology, 2021, 134(6): 887-900.
36
Neto AS, da Costa L, Hemmes S, et al. The LAS VEGAS risk score for prediction of postoperative pulmonary complications: An observational study [J]. Eur J Anaesthesiol, 2018, 35(9): 691-701.
37
Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis [J]. Am J Med, 2011, 124(2): 144-154.e8.
38
Wong J, Lam DP, Abrishami A, et al. Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis [J]. Can J Anaesth, 2012, 59(3): 268-279.
39
Myers K, Hajek P, Hinds C, et al. Stopping smoking shortly before surgery and postoperative complications: a systematic review and meta-analysis [J]. Arch Intern Med, 2011, 171(11): 983-989.
40
Razo Vazquez AO, Rosenbaum S. Anesthesia for adults with upper respiratory infection[EB/OL]. (2021-12-07)[2022-11-01].

URL    
41
Odor PM, Bampoe S, Gilhooly D, et al. Perioperative interventions for prevention of postoperative pulmonary complications: systematic review and meta-analysis [J]. BMJ, 2020, 368: m540.
42
Silvanus MT, Groeben H, Peters J. Corticosteroids and inhaled salbutamol in patients with reversible airway obstruction markedly decrease the incidence of bronchospasm after tracheal intubation [J]. Anesthesiology, 2004, 100(5): 1052-1057.
43
支修益, 刘伦旭. 中国胸外科围手术期气道管理指南(2020版) [J]. 中国胸心血管外科临床杂志, 2021, 28(3): 251-262.
44
Tietjens JR, Claman D, Kezirian EJ, et al. Obstructive sleep apnea in cardiovascular disease: a review of the literature and proposed multidisciplinary clinical management strategy [J]. J Am Heart Assoc, 2019, 8(1): e010440.
45
Goodenough CJ, Liang MK, Nguyen MT, et al. Preoperative glycosylated hemoglobin and postoperative glucose together predict major complications after abdominal surgery [J]. J Am Coll Surg, 2015, 221(4): 854-861.e1.
46
Zhang RH, Cai YH, Shu LP, et al. Bidirectional relationship between diabetes and pulmonary function: a systematic review and meta-analysis [J]. Diabetes Metab, 2021, 47(5): 101186.
47
Lauruschkat AH, Arnrich B, Albert AA, et al. Diabetes mellitus as a risk factor for pulmonary complications after coronary bypass surgery [J]. J Thorac Cardiovasc Surg, 2008, 135(5): 1047-1053.
48
American Diabetes Association Professional Practice Committee. 13. Older Adults: Standards of Medical Care in Diabetes-2022 [J]. Diabetes Care, 2022, 45(Suppl 1): S195-S207.
49
Unal D, Senayli Y, Polat R, et al. Peri-operative blood transfusion in elective major surgery: incidence, indications and outcome-an observational multicentre study [J]. Blood Transfus, 2020, 18(4): 261-279.
50
Phan K, Wang N, Kim JS, et al. Effect of preoperative anemia on the outcomes of anterior cervical discectomy and fusion [J]. Global Spine J, 2017, 7(5): 441-447.
51
Güldner A, Spieth PM, Gama de Abreu M. Non-ventilatory approaches to prevent postoperative pulmonary complications [J]. Best Pract Res Clin Anaesthesiol, 2015, 29(3): 397-410.
52
Grams ST, Ono LM, Noronha MA, et al. Breathing exercises in upper abdominal surgery: a systematic review and meta-analysis [J]. Rev Bras Fisioter, 2012, 16(5): 345-353.
53
Batchelor T, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS) [J]. Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
54
Boden I, Skinner EH, Browning L, et al. Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial [J]. BMJ, 2018, 360: j5916.
55
Vogiatzis I, Terzis G, Stratakos G, et al. Effect of pulmonary rehabilitation on peripheral muscle fiber remodeling in patients with COPD in GOLD stages Ⅱ to Ⅳ [J]. Chest, 2011, 140(3): 744-752.
56
Hulzebos EH, Helders PJ, Favié NJ, et al. Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial [J]. JAMA, 2006, 296(15): 1851-1857.
57
Rigg JR, Jamrozik K, Myles PS, et al. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial [J]. Lancet, 2002, 359(9314): 1276-1282.
58
魏滨, 张华, 徐懋, 等. 不同麻醉方法对髋部骨折老年患者术后转归的影响 [J]. 北京大学学报(医学版), 2017, 49 (6): 1008-1013.
59
Chery J, Semaan E, Darji S, et al. Impact of regional versus general anesthesia on the clinical outcomes of patients undergoing major lower extremity amputation [J]. Ann Vasc Surg, 2014,28(5):1149-1156.
60
Hausman MSJr, Jewell ES, Engoren M. Regional versus general anesthesia in surgical patients with chronic obstructive pulmonary disease: does avoiding general anesthesia reduce the risk of postoperative complications? [J]. Anesth Analg, 2015, 120(6): 1405-1412.
61
Guay J, Choi P, Suresh S, et al. Neuraxial blockade for the prevention of postoperative mortality and major morbidity: an overview of Cochrane systematic reviews [J]. Cochrane Database Syst Rev, 2014, 2014(1): CD010108.
62
Neuman MD, Feng R, Carson JL, et al. Spinal anesthesia or general anesthesia for hip surgery in older adults [J]. N Engl J Med, 2021, 385(22): 2025-2035.
63
Bartels K, Frendl G, Sprung J, et al. Postoperative pulmonary complications with adjuvant regional anesthesia versus general anesthesia alone: a sub-analysis of the Perioperative Research Network study [J]. BMC Anesthesiol, 2022, 22(1): 136.
64
杨瑜汀, 朱辉, 於章杰, 等. 喉罩通气应用于老年患者腹部手术麻醉对术后肺部并发症的影响 [J].上海医学, 2015, 38(4): 290-293.
65
Hammer M, Santer P, Schaefer MS, et al. Supraglottic airway device versus tracheal intubation and the risk of emergent postoperative intubation after general anaesthesia in adults: a retrospective cohort study [J]. Br J Anaesth, 2021, 126(3): 738-745.
66
El Solh AA, Bhora M, Pineda L, et al. Nosocomial pneumonia in elderly patients following cardiac surgery [J]. Respir Med, 2006, 100(4): 729-736.
67
Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery [J]. Am J Health Syst Pharm, 2013, 70(3): 195-283.
68
Hochreiter M, Uhling M, Sisic L, et al. Prolonged antibiotic prophylaxis after thoracoabdominal esophagectomy does not reduce the risk of pneumonia in the first 30 days: a retrospective before-and-after analysis [J]. Infection, 2018, 46(5): 617-624.
69
Couture EJ, Provencher S, Somma J, et al. Effect of position and positive pressure ventilation on functional residual capacity in morbidly obese patients: a randomized trial [J]. Can J Anaesth, 2018, 65(5): 522-528.
70
Pang QY, Mo J, An R, et al. Meta-analysis of the optimal ventilation strategies to improve perioperative oxygenation in obese patients [J]. Int J Clin Exp Med, 2017, 10(5883): e91.
71
Futier E, Constantin JM, Paugam-Burtz C, et al. A trial of intraoperative low-tidal-volume ventilation in abdominal surgery [J]. N Engl J Med, 2013, 369(5): 428-437.
72
Yang D, Grant MC, Stone A, et al. A meta-analysis of intraoperative ventilation strategies to prevent pulmonary complications: is low tidal volume alone sufficient to protect healthy lungs? [J]. Ann Surg, 2016, 263(5): 881-887.
73
Akkermans A, van Waes JA, Kheterpal S, et al. Outlying end-tidal carbon dioxide during general anesthesia is associated with postoperative pulmonary complications: a multicenter retrospective observational study from us hospitals between 2010 and 2017 [J]. Anesth Analg, 2022, 135(2): 341-353.
74
Bagchi A, Rudolph MI, Ng PY, et al. The association of postoperative pulmonary complications in 109,360 patients with pressure-controlled or volume-controlled ventilation [J]. Anaesthesia, 2017, 72(11): 1334-1343.
75
Aldenkortt M, Lysakowski C, Elia N, et al. Ventilation strategies in obese patients undergoing surgery: a quantitative systematic review and meta-analysis [J]. Br J Anaesth, 2012, 109(4): 493-502.
76
Jiang J, Li B, Kang N, et al. Pressure-controlled versus volume-controlled ventilation for surgical patients: a systematic review and meta-analysis [J]. J Cardiothorac Vasc Anesth, 2016, 30(2): 501-514.
77
Schick V, Dusse F, Eckardt R, et al. Comparison of volume-guaranteed or -targeted, pressure-controlled ventilation with volume-controlled ventilation during elective surgery: a systematic review and meta-analysis [J]. J Clin Med, 2021, 10(6): 1276.
78
Cui Y, Cao R, Li G, et al. The effect of lung recruitment maneuvers on post-operative pulmonary complications for patients undergoing general anesthesia: A meta-analysis [J]. PLoS One, 2019, 14(5): e0217405.
79
Hartland BL, Newell TJ, Damico N. Alveolar recruitment maneuvers under general anesthesia: a systematic review of the literature [J]. Respir Care, 2015, 60(4): 609-620.
80
Young CC, Harris EM, Vacchiano C, et al. Lung-protective ventilation for the surgical patient: international expert panel-based consensus recommendations [J]. Br J Anaesth, 2019, 123(6): 898-913.
81
Rothen HU, Neumann P, Berglund JE, et al. Dynamics of re-expansion of atelectasis during general anaesthesia [J]. Br J Anaesth, 1999, 82(4): 551-556.
82
Güldner A, Kiss T, Serpa Neto A, et al. Intraoperative protective mechanical ventilation for prevention of postoperative pulmonary complications: a comprehensive review of the role of tidal volume, positive end-expiratory pressure, and lung recruitment maneuvers [J]. Anesthesiology, 2015, 123(3): 692-713.
83
De Jong A, Wrigge H, Hedenstierna G, et al. How to ventilate obese patients in the ICU [J]. Intensive Care Med, 2020, 46(12): 2423-2435.
84
Godet T, Constantin JM, Jaber S, et al. How to monitor a recruitment maneuver at the bedside [J]. Curr Opin Crit Care, 2015, 21(3): 253-258.
85
Hedenstierna G, Edmark L. Mechanisms of atelectasis in the perioperative period [J]. Best Pract Res Clin Anaesthesiol, 2010, 24(2): 157-169.
86
Millington SJ, Cardinal P, Brochard L. Setting and titrating positive end-expiratory pressure [J]. Chest, 2022, 161(6): 1566-1575.
87
Alviar CL, Rico-Mesa JS, Morrow DA, et al. Positive pressure ventilation in cardiogenic shock: review of the evidence and practical advice for patients with mechanical circulatory support [J]. Can J Cardiol, 2020, 36(2): 300-312.
88
Bouhemad B, Brisson H, Le-Guen M, et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment [J]. Am J Respir Crit Care Med, 2011, 183(3): 341-347.
89
Su PL, Lin WC, Ko YF, et al. Electrical impedance tomography analysis between two similar respiratory system compliance during decremetal PEEP titration in ARDS patients [J]. J Med Biol Eng, 2021, 41(6): 888-894.
90
Mauri T, Yoshida T, Bellani G, et al. Esophageal and transpulmonary pressure in the clinical setting: meaning, usefulness and perspectives [J]. Intensive Care Med, 2016, 42(9): 1360-1373.
91
Zhao Z, Steinmann D, Frerichs I, et al. PEEP titration guided by ventilation homogeneity: a feasibility study using electrical impedance tomography [J]. Crit Care, 2010, 14(1): R8.
92
Jo YY, Kim JY, Park CK, et al. The effect of ventilation strategy on arterial and cerebral oxygenation during laparoscopic bariatric surgery [J]. Obes Surg, 2016, 26(2): 339-344.
93
Kim WH, Hahm TS, Kim JA, et al. Prolonged inspiratory time produces better gas exchange in patients undergoing laparoscopic surgery: a randomised trial [J]. Acta Anaesthesiol Scand, 2013, 57(5): 613-622.
94
Kim MS, Kim NY, Lee KY, et al. The impact of two different inspiratory to expiratory ratios (1:1 and 1:2) on respiratory mechanics and oxygenation during volume-controlled ventilation in robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial [J]. Can J Anaesth, 2015, 62(9): 979-987.
95
Zhang WP, Zhu SM. The effects of inverse ratio ventilation on cardiopulmonary function and inflammatory cytokine of bronchoaveolar lavage in obese patients undergoing gynecological laparoscopy [J]. Acta Anaesthesiol Taiwan, 2016, 54(1): 1-5.
96
Staehr-Rye AK, Meyhoff CS, Scheffenbichler FT, et al. High intraoperative inspiratory oxygen fraction and risk of major respiratory complications [J]. Br J Anaesth, 2017, 119(1): 140-149.
97
de Jonge S, Egger M, Latif A, et al. Effectiveness of 80% vs 30-35% fraction of inspired oxygen in patients undergoing surgery: an updated systematic review and meta-analysis [J]. Br J Anaesth, 2019, 122(3): 325-334.
98
Ottolenghi S, Sabbatini G, Brizzolari A, et al. Hyperoxia and oxidative stress in anesthesia and critical care medicine [J]. Minerva Anestesiol, 2020, 86(1): 64-75.
99
Feihl F, Perret C. Permissive hypercapnia. How permissive should we be? [J]. Am J Respir Crit Care Med, 1994, 150(6 Pt 1): 1722-1737.
100
Contreras M, Masterson C, Laffey JG. Permissive hypercapnia: what to remember [J]. Curr Opin Anaesthesiol, 2015, 28(1): 26-37.
101
Cecconi M, Corredor C, Arulkumaran N, et al. Clinical review: goal-directed therapy-what is the evidence in surgical patients? The effect on different risk groups [J]. Crit Care, 2013, 17(2): 209.
102
Cecconi M, Parsons AK, Rhodes A. What is a fluid challenge? [J]. Curr Opin Crit Care, 2011, 17(3): 290-295.
103
Huang CC, Kao KC, Hsu KH, et al. Effects of hydroxyethyl starch resuscitation on extravascular lung water and pulmonary permeability in sepsis-related acute respiratory distress syndrome [J]. Crit Care Med, 2009, 37(6): 1948-1955.
104
Tuinman PR, Vlaar AP, Cornet AD, et al. Blood transfusion during cardiac surgery is associated with inflammation and coagulation in the lung: a case control study [J]. Crit Care, 2011, 15(1): R59.
105
McVey MJ, Kapur R, Cserti-Gazdewich C, et al. Transfusion-related Acute Lung Injury in the Perioperative Patient [J]. Anesthesiology, 2019, 131(3): 693-715.
106
魏超, 庄远, 陈麟凤, 等. 体外循环冠脉搭桥患者围术期输红细胞量的评估及其对术后肺部并发症的影响分析 [J]. 中国实验血液学杂志, 2014, 22(1): 204-208.
107
Zeng Q, Tan S, Bao Q, et al. Intra-operative blood transfusion significantly increases the risk of post-operative pulmonary embolism [J]. J Thorac Dis, 2019, 11(12): 5566-5571.
108
Chen QH, Wang HL, Liu L, et al. Effects of restrictive red blood cell transfusion on the prognoses of adult patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials [J]. Crit Care, 2018, 22(1): 142.
109
Ducrocq G, Gonzalez-Juanatey JR, Puymirat E, et al. Effect of a restrictive vs liberal blood transfusion strategy on major cardiovascular events among patients with acute myocardial infarction and anemia: the REALITY randomized clinical trial [J]. JAMA, 2021, 325(6): 552-560.
110
Carson JL, Guyatt G, Heddle NM, et al. Clinical practice guidelines from the AABB: red blood cell transfusion thresholds and storage [J]. JAMA, 2016, 316(19): 2025-2035.
111
Tibi P, McClure RS, Huang J, et al. STS/SCA/AmSECT/SABM update to the clinical practice guidelines on patient blood management [J]. J Cardiothorac Vasc Anesth, 2021, 35(9): 2569-2591.
112
Hameed I, Cifu AS, Geirsson A. Blood management in high-risk surgery [J]. JAMA, 2022, 327(6): 578-579.
113
Shi J, Zhou C, Pan W, et al. Effect of high- vs low-dose tranexamic acid infusion on need for red blood cell transfusion and adverse events in patients undergoing cardiac surgery: the OPTIMAL randomized clinical trial [J]. JAMA, 2022, 328(4): 336-347.
114
Heinze H, Sedemund-Adib B, Heringlake M, et al. Changes in functional residual capacity during weaning from mechanical ventilation: a pilot study [J]. Anesth Analg, 2009, 108(3): 911-915.
115
Neligan PJ, Malhotra G, Fraser M, et al. Continuous positive airway pressure via the Boussignac system immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery [J]. Anesthesiology, 2009, 110(4): 878-884.
116
Singh PM, Borle A, Shah D, et al. Optimizing prophylactic CPAP in patients without obstructive sleep apnoea for high-risk abdominal surgeries: a meta-regression analysis [J]. Lung, 2016, 194(2): 201-217.
117
Hewidy AA, Suliman LA, Hefnawy EE, et al. Immediate continuous positive airway pressure (CPAP) therapy after sleeve gastrectomy [J]. Egypt J Chest Dis Tuberc, 2016, 65(3): 701-706.
118
Edmark L, Auner U, Lindbäck J, et al. Post-operative atelectasis - a randomised trial investigating a ventilatory strategy and low oxygen fraction during recovery [J]. Acta Anaesthesiol Scand, 2014, 58(6): 681-688.
119
Östberg E, Auner U, Enlund M, et al. Minimizing atelectasis formation during general anaesthesia-oxygen washout is a non-essential supplement to PEEP [J]. Ups J Med Sci, 2017, 122(2): 92-98.
120
Hunter JM. Reversal of residual neuromuscular block: complications associated with perioperative management of muscle relaxation [J]. Br J Anaesth, 2017, 119(suppl_1): i53-i62.
121
Ball L, de Abreu MG, Schultz MJ, et al. Neuromuscular blocking agents and postoperative pulmonary complications [J]. Lancet Respir Med, 2019, 7(2): 102-103.
122
Kheterpal S, Vaughn MT, Dubovoy TZ, et al. Sugammadex versus neostigmine for reversal of neuromuscular blockade and postoperative pulmonary complications (STRONGER): a multicenter matched cohort analysis [J]. Anesthesiology, 2020, 132(6): 1371-1381.
123
Ledowski T, Szabó-Maák Z, Loh PS, et al. Reversal of residual neuromuscular block with neostigmine or sugammadex and postoperative pulmonary complications: a prospective, randomised, double-blind trial in high-risk older patients [J]. Br J Anaesth, 2021, 127(2): 316-323.
124
Cho SA, Sung TY. Choice of neuromuscular block reversal agent to reduce postoperative pulmonary complications [J]. Anesth Pain Med (Seoul), 2022, 17(2): 121-131.
125
Lawrence VA, Cornell JE, Smetana GW, et al. Strategies to reduce postoperative pulmonary complications after noncardiothoracic surgery: systematic review for the American College of Physicians [J]. Ann Intern Med, 2006, 144(8): 596-608.
126
Liu SS, Wu CL. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence [J]. Anesth Analg, 2007, 104(3): 689-702.
127
Cense HA, Lagarde SM, de Jong K, et al. Association of no epidural analgesia with postoperative morbidity and mortality after transthoracic esophageal cancer resection [J]. J Am Coll Surg, 2006, 202(3): 395-400.
128
Yeung JH, Gates S, Naidu BV, et al. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy [J]. Cochrane Database Syst Rev, 2016, 2(2): CD009121.
129
Pöpping DM, Elia N, Marret E, et al. Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta-analysis [J]. Arch Surg, 2008, 143(10): 990-999.
130
Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists [J]. Surg Obes Relat Dis, 2020, 16(2): 175-247.
131
Cassidy MR, Rosenkranz P, McCabe K, et al. I COUGH: reducing postoperative pulmonary complications with a multidisciplinary patient care program [J]. JAMA Surg, 2013, 148(8): 740-745.
132
Haines KJ, Skinner EH, Berney S, et al. Association of postoperative pulmonary complications with delayed mobilisation following major abdominal surgery: an observational cohort study [J]. Physiotherapy, 2013, 99(2): 119-125.
133
van der Leeden M, Huijsmans R, Geleijn E, et al. Early enforced mobilisation following surgery for gastrointestinal cancer: feasibility and outcomes [J]. Physiotherapy, 2016, 102(1): 103-110.
134
Jones LW. Physical activity and lung cancer survivorship [J]. Recent Results Cancer Res, 2011, 186: 255-274.
135
Aceto P, Antonelli Incalzi R, Bettelli G, et al. Perioperative management of elderly patients (PriME): recommendations from an Italian intersociety consensus [J]. Aging Clin Exp Res, 2020, 32(9): 1647-1673.
136
Lunardi AC, Cecconello I, Carvalho CR. Postoperative chest physical therapy prevents respiratory complications in patients undergoing esophagectomy [J]. Rev Bras Fisioter, 2011, 15(2): 160-165.
137
van Lier F, van der Geest PJ, Hol JW, et al. Risk modification for postoperative pulmonary embolism: timing of postoperative prophylaxis [J]. Thromb Res, 2012, 129(4): e14-e17.
138
Blitzer RR, Eisenstein S. Venous thromboembolism and pulmonary embolism: strategies for prevention and management [J]. Surg Clin North Am, 2021, 101(5): 925-938.
139
Urbankova J, Quiroz R, Kucher N, et al. Intermittent pneumatic compression and deep vein thrombosis prevention. A meta-analysis in postoperative patients [J]. Thromb Haemost, 2005, 94(6): 1181-1185.
140
Beitland S, Sandven I, Kjærvik LK, et al. Thromboprophylaxis with low molecular weight heparin versus unfractionated heparin in intensive care patients: a systematic review with meta-analysis and trial sequential analysis [J]. Intensive Care Med, 2015, 41(7): 1209-1219.
141
Neto AS, Hemmes SN, Barbas CS, et al. Association between driving pressure and development of postoperative pulmonary complications in patients undergoing mechanical ventilation for general anaesthesia: a meta-analysis of individual patient data [J]. Lancet Respir Med, 2016, 4(4): 272-280.
142
Amato MB, Meade MO, Slutsky AS, et al. Driving pressure and survival in the acute respiratory distress syndrome [J]. N Engl J Med, 2015, 372(8): 747-755.
143
Harris RS. Pressure-volume curves of the respiratory system [J]. Respir Care, 2005, 50(1): 78-98.
144
Zhang Y, Xiong X, Dai F, et al. Curvilinearity of a maximum expiratory flow-volume curve: a useful indicator for assessing airway obstruction in children with asthma [J]. Respir Care, 2020, 65(4): 427-436.
145
Yoshida T, Brochard L. Esophageal pressure monitoring: why, when and how? [J]. Curr Opin Crit Care, 2018,24(3):216-222.
146
Talmor D, Sarge T, Malhotra A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury [J]. N Engl J Med, 2008, 359(20): 2095-2104.
147
Douville NJ, Jewell ES, Duggal N, et al. Association of intraoperative ventilator management with postoperative oxygenation, pulmonary complications, and mortality [J]. Anesth Analg, 2020, 130(1): 165-175.
148
Touw HR, Parlevliet KL, Beerepoot M, et al. Lung ultrasound compared with chest X-ray in diagnosing postoperative pulmonary complications following cardiothoracic surgery: a prospective observational study [J]. Anaesthesia, 2018, 73(8): 946-954.
149
Mojoli F, Bouhemad B, Mongodi S, et al. Lung ultrasound for critically ill patients [J]. Am J Respir Crit Care Med, 2019, 199(6): 701-714.
150
Strapazzon G, Vezzaro R, Hofer G, et al. Factors associated with B-lines after exposure to hypobaric hypoxia [J]. Eur Heart J Cardiovasc Imaging, 2015, 16(11): 1241-1246.
151
Borges JB, Suarez-Sipmann F, Bohm SH, et al. Regional lung perfusion estimated by electrical impedance tomography in a piglet model of lung collapse [J]. J Appl Physiol (1985), 2012, 112(1): 225-236.
152
Wang X, Zhao H, Cui N. The role of electrical impedance tomography for management of high-risk pulmonary embolism in a postoperative patient [J]. Front Med (Lausanne), 2021, 8: 773471.
153
Spinelli E, Kircher M, Stender B, et al. Unmatched ventilation and perfusion measured by electrical impedance tomography predicts the outcome of ARDS [J]. Crit Care, 2021, 25(1): 192.
154
Kacmarek RM, Wanderley HV, Villar J, et al. Weaning patients with obesity from ventilatory support [J]. Curr Opin Crit Care, 2021, 27(3): 311-319.
155
Neira VM, Kovesi T, Guerra L, et al. The impact of pneumoperitoneum and Trendelenburg positioning on respiratory system mechanics during laparoscopic pelvic surgery in children: a prospective observational study [J]. Can J Anaesth, 2015, 62(7): 798-806.
156
Wang P, Zhao S, Gao Z, et al. Use of volume controlled vs. pressure controlled volume guaranteed ventilation in elderly patients undergoing laparoscopic surgery with laryngeal mask airway [J]. BMC Anesthesiol, 2021, 21(1): 69.
157
Blank RS, Colquhoun DA, Durieux ME, et al. Management of One-lung Ventilation: Impact of Tidal Volume on Complications after Thoracic Surgery [J]. Anesthesiology, 2016, 124(6): 1286-1295.
158
Park M, Ahn HJ, Kim JA, et al. Driving pressure during thoracic surgery: a randomized clinical trial [J]. Anesthesiology, 2019, 130(3): 385-393.
159
Wysham WZ, Kim KH, Roberts JM, et al. Obesity and perioperative pulmonary complications in robotic gynecologic surgery [J]. Am J Obstet Gynecol, 2015, 213(1): e31-e37.
160
Ball L, Hemmes S, Serpa Neto A, et al. Intraoperative ventilation settings and their associations with postoperative pulmonary complications in obese patients [J]. Br J Anaesth, 2018, 121(4): 899-908.
161
Scheib SA, Tanner E3rd, Green IC, et al. Laparoscopy in the morbidly obese: physiologic considerations and surgical techniques to optimize success [J]. J Minim Invasive Gynecol, 2014, 21(2): 182-195.
162
Cadi P, Guenoun T, Journois D, et al. Pressure-controlled ventilation improves oxygenation during laparoscopic obesity surgery compared with volume-controlled ventilation [J]. Br J Anaesth, 2008, 100(5): 709-716.
163
Gupta H, Ramanan B, Gupta PK, et al. Impact of COPD on postoperative outcomes: results from a national database [J]. Chest, 2013, 143(6): 1599-1606.
164
Thomsen M, Nordestgaard BG, Vestbo J, et al. Characteristics and outcomes of chronic obstructive pulmonary disease in never smokers in Denmark: a prospective population study [J]. Lancet Respir Med, 2013, 1(7): 543-550.
165
Nici L, Donner C, Wouters E, et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation [J]. Am J Respir Crit Care Med, 2006, 173(12): 1390-1413.
166
Osadnik CR, Singh S. Pulmonary rehabilitation for obstructive lung disease [J]. Respirology, 2019, 24(9): 871-878.
167
Shin B, Lee H, Kang D, et al. Airflow limitation severity and post-operative pulmonary complications following extra-pulmonary surgery in COPD patients [J]. Respirology, 2017, 22(5): 935-941.
168
Numata T, Nakayama K, Fujii S, et al. Risk factors of postoperative pulmonary complications in patients with asthma and COPD [J]. BMC Pulm Med, 2018, 18(1): 4.
169
Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary [J]. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
170
Voltolini L, Bongiolatti S, Luzzi L, et al. Impact of interstitial lung disease on short-term and long-term survival of patients undergoing surgery for non-small-cell lung cancer: analysis of risk factors [J]. Eur J Cardiothorac Surg, 2013, 43(1): e17-e23.
171
Park JS, Kim HK, Kim K, et al. Prediction of acute pulmonary complications after resection of lung cancer in patients with preexisting interstitial lung disease [J]. Thorac Cardiovasc Surg, 2011, 59(3): 148-152.
172
den Hengst WA, Gielis JF, Lin JY, et al. Lung ischemia-reperfusion injury: a molecular and clinical view on a complex pathophysiological process [J]. Am J Physiol Heart Circ Physiol, 2010, 299(5): H1283-H1299.
173
Schreiber JU, Lancé MD, de Korte M, et al. The effect of different lung-protective strategies in patients during cardiopulmonary bypass: a meta-analysis and semiquantitative review of randomized trials [J]. J Cardiothorac Vasc Anesth, 2012, 26(3): 448-454.
174
Mathis MR, Duggal NM, Likosky DS, et al. Intraoperative mechanical ventilation and postoperative pulmonary complications after cardiac surgery [J]. Anesthesiology, 2019, 131(5): 1046-1062.
175
Jalbert JJ, Nguyen LL, Gerhard-Herman MD, et al. Outcomes after carotid artery stenting in Medicare beneficiaries, 2005 to 2009 [J]. JAMA Neurol, 2015, 72(3): 276-286.
176
David RA, Brooke BS, Hanson KT, et al. Early extubation is associated with reduced length of stay and improved outcomes after elective aortic surgery in the Vascular Quality Initiative [J]. J Vasc Surg, 2017, 66(1): 79-94.
177
Nakazato K, Takeda S, Tanaka K, et al. Aggressive treatment with noninvasive ventilation for mild acute hypoxemic respiratory failure after cardiovascular surgery: retrospective observational study [J]. J Cardiothorac Surg, 2012, 7: 41.
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