RELATION OF VOLEMIC SUPPORT TO ACUTE POSTOPERATIVE RESPIRATORY INSUFFICIENCY DEVELOPMENT FOLLOWING THORACIC ONCOLOGICAL SURGERY

Abstract

Acute postoperative respiratory insufficiency is a serious complication after thoracic surgery. Оur aim is to define the relation of rate and volume of infusion during the operation with development of acute postoperative respiratory insufficiency in patients operated on for lung cancer. We performed a retrospective assessment of 416 patients with various rate of intraoperative infusion that were divided into 2 groups: with acute postoperative respiratory insufficiency (ARI, n = 53) and without it (n = 319). As a continuous covariate in each group we analysed intraoperative infusion rate in the range 2, 3, 4, 5, 6, 7 and 8 ml/kg*h. Intraoperative infusion rate more than 5 ml/kg*h, positive fluid balance, low measurements SvO2 and lower PaO2/FiO2 ratio intraoperatively , are shown as valuable predictors for postoperative ARI development. Intraoperatively we found a strong correlation (r = 0.915697) between infusion rate and frequency of postoperative ARI, and defined optimal infusion rate (to 5 ml/kg* h) which allowed to decrease possible development of ARI, length of hospital stay to 53.4% and mortality from 11.3 to 0%.

Keywords

• acute postoperative respiratory insufficiency
• fluid maintenance
• venous oximetry
• pao₂/fio₂ ratio