New Tool Helps Predict Surgical Patients' Pulmonary Risk
Estimates put mechanical ventilation expenditure at $1,522 per day per patient in the intensive care unit. Although the need for ventilation is not widespread — about one to three percent of patients who have non-emergency surgical procedures require ventilation afterward — the consequences are nonetheless significant, according to researchers.
"The need for artificial mechanical ventilation after operations is infrequent, but when it happens it does carry high costs," says study co-author Adam P. Johnson, MD, MPH. "Ventilator dependence is highly associated with mortality, and in and of itself is a morbidity."
The Jefferson team examined ACS NSQIP data on 7,473 patients who had elective general or vascular operations at the institution between 2006 and 2013. The scoring system assigned points for different factors, such as current smoker (1 point), age older than 60 years (2 points), and oesophagus procedures (3 points). Total risk scores ranged from 0 to 7 for study subjects. The median risk score for patients who did not need the ventilator after operations was 2, while that for patients who did need the ventilator was 3. Those with a score above 3 comprised the 20 percent of patients who experienced 70 percent of adverse events, the researchers explained.
Other risk factors associated with postoperative ventilator dependence were a diagnosis of severe chronic obstructive pulmonary disease; signs of active infection or inflammatory response; and low albumin counts, a sign of malnutrition. "Our goal was to quantify how each factor affects the risk of ventilator dependence," said Dr. Johnson. After identifying this smaller set of high risk patients, "the goal then is to optimise them before and during their hospital stay," he added.
The team says other hospitals may be able to use the scoring system to identify ventilator dependence risks in their own patient populations. "Our institution's risk score may not be generalisable, but the methodology of how we developed and then implemented the risk score may be used at other hospitals when looking at their own patients," Dr. Johnson said.
The findings were presented at the 2015 American College of Surgeons National Surgical Quality Improvement Program Conference.
Source: American College of Surgeons
Image credit: Google images
new method to avoid costly postoperative ventilation
Published on : Thu, 30 Jul 2015
NovaPort cannulas are designed specially to meet the needs of extracorporeal lung and heart support circuits and perioperative perfusion in minimally invasive heart surgery. All blood-contact surfaces of the NovaPort cannulas are coated with the bio-...
The HAMILTON-T1 combines for the first time the functionality of a fully featured intensive care unit ventilator with the compactness and ruggedness required for transport. This is why the HAMILTON-T1 enables you to provide optimal ventilation therapy...
The iLA Membrane Ventilator is an extrapulmonary ventilation system which is used primarily to remove carbon dioxide. The heart pumps blood through it as it does through a natural organ. The gas exchange takes place via a plasma-tight, heparin-coated...
Medos customized tubing sets have been individually designed, so that all customer requirements, depending on application and need can be realized. Furthermore tubing sets can be refined by rheoparin or x.eed coating.
Designed for many applications. Venue is a multi-purpose, point of care system that is also well-suited to help you manage patients in shock. It includes automated tools that enable you to quickly get the information you need to make fast decisions...