RT Journal Article
SR Electronic
T1 Perioperative Factors Associated With Respiratory Complications Following Open Abdomen Management
JF Respiratory Care
FD American Association for Respiratory Care
SP 1663
OP 1667
DO 10.4187/respcare.07657
VO 65
IS 11
A1 Inukai, Koichi
A1 Usui, Akihiro
A1 Amano, Koji
A1 Kayata, Hiroyuki
A1 Mukai, Nobutaka
A1 Tsunetoshi, Yusuke
A1 Nakata, Yasuki
YR 2020
UL http://rc.rcjournal.com/content/65/11/1663.abstract
AB BACKGROUND: Postoperative respiratory complications are often severe and associated with a high risk of mortality in patients who undergo open abdomen (OA) management following emergency damage-control surgery. The causes of postoperative respiratory complications remain unknown. Therefore, we evaluated postoperative factors associated with respiratory complications in nontrauma patients who had undergone OA management using propensity score matching, with a focus on OA-related risk factors.METHODS: This retrospective analysis included subjects who underwent OA management during a 4-y study period. Age, body mass index, and smoking history were selected as covariates. After propensity score matching, we compared postoperative factors (ie, first operative time, duration of OA, initial 3-d fluid balance, length of ICU stay, and in-hospital mortality) in 2 groups of subjects: those who had post-OA respiratory complications (PORCs) and those who did not.RESULTS: 60 subjects (33 men and 27 women) were identified; 38.3% of these subjects had PORCs. After propensity score matching, 18 subjects were matched. The 3-d fluid balance was significantly higher in subjects with PORCs than in those without PORCs (3,513 mL vs 1,087 mL; P = .03).CONCLUSIONS: To our knowledge, this is the first study to examine factors associated with respiratory complications following OA in nontrauma subjects. After adjusting for known co-factors associated with postoperative respiratory complications, the 3-d fluid balance was identified as a significant risk factor for PORCs in subjects who had undergone OA. Clinicians should pay attention to the incidence of PORCs in OA subjects with a positive fluid balance after emergency abdominal surgery.