Postoperative Pulmonary Complications: A Review of the Literature and Implications for Practice

Abstract

Postoperative pulmonary complications (PPCs) remain a major concern despite advancements in the healthcare system. The rate of occurrence of PPCs can vary greatly according to factors related to the patient and the surgery itself. The term PPCs refers to a variety of respiratory conditions that can occur, typically within the first seven days following surgery. Examples of these conditions are atelectasis, chest infection, and respiratory failure. When functional residual capacity (FRC) is reduced, it can lead to changes in the ventilation-perfusion (V/Q) ratio which can lead to the development of atelectasis.It may take several days for the alveolar-to-arterial oxygen difference to return to normal. There have been numerous published prediction models for PPCs such as ARISCAT score, PERISCOPE, and LAS VEGAS score but many of them have limitations. PPCs have been associated with higher postoperative morbidity, and prolonged hospital stay which in turn results in higher healthcare costs. As such, it is important for anesthetists and surgeons to be cautious of patients at higher risk and take preventative strategies to lower PPCs.