Advances in Airway Management-气道管理新进展Tongji Lung protective ventilation.pptx

Sealing Out DoubtAdvances in Airway Management气道管理新进展 DisclosureMark Procyshyn, RRT is the Senior Regional Marketing Manager for Covidien’s Respiratory Division in Asia.Outline:What are postoperative pulmonary complications? 何为术后肺部并发症What is their significance in terms of:Incidence? 发生率？Clinical outcomes? 临床结果？Postoperative Pulmonary Complications术后肺部并发症These complications range from minor, self-limited conditions to major disease states with significant morbidity and mortality. 这些并发症小至自限性疾病，大至具有较高发病率和死亡率的疾病。The most commonly cited examples in the clinical literature are:1 在医学文献中最常见引用的并发症是：Pneumonia 肺炎Respiratory failure 呼吸衰竭Atelectasis 肺不张Acute exacerbation of chronic lung disease 慢性肺部疾病的急性加重Other prominent examples include ARDS, bronchospasm, tracheobronchitis and perioperative hypoxia. 其他突出的并发症包括：ARDS，支气管痉挛，支气管炎，术中低氧血症1. Arozullah et al. Ann Surg. 2000;232(2):242-253.Outline:What are postoperative pulmonary complications?何为术后肺部并发症What is their significance in terms of:Incidence? 发生率？ Clinical outcomes?Postoperative Pulmonary Complications Are Surprisingly Common术后肺部并发症十分常见Summary of studies investigating incidence of postoperative pulmonary complications by surgical site, as per systematic literature review in 20061 2006年不同部位外科手术后术后肺部并发症发生率研究的概要Surgical siteReported complication rateStudies, nAAA repair 腹主动脉瘤切除术25.5%16Esophagectomy 食道切除术18.9%11Abdominal surgery 腹部手术14.2%43Head and neck surgery 头颈部手术10.3%6Hip surgery 髋部手术5.1%5Gynecologic/Urologic procedures 妇科/泌尿科操作1.8%2Multiple studies show the high incidence of postoperative pulmonary complications.多项研究先提示术后肺部并发症的发生率较高。1. Smetana et al. Ann Intern Med. 2006;144:581-95.Postoperative Pulmonary Complications Deserve Equal Attention with Perioperative Cardiac Complications术后肺部并发症应与术中心脏并发症一样引起重视Retrospective multicenter cohort study of 8,930 patients 60 years or older for hip surgery1针对8930例60岁以上髋部手术患者的多中心回顾性队列研究，ComplicationIncidence30-day mortality1-year mortalitySerious cardiac*严重的心血管疾病2.0%22%36%Serious pulmo