Pulmonary surgery, intensive care, effective intensive care use, adverse events
Conditions
Interventions
None listed
Sponsors
Amphia Hospital
Eligibility
Inclusion criteria
Inclusion criteria: Patients that underwent elective pulmonary surgery (pneumonectomy, (bi)(sleeve)lobectomy, segmentectomy), with a postoperative admission to the ICU are included.
Exclusion criteria
Exclusion criteria: Intraoperative death.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| -invasive mechanical ventilation (initiated on the ICU or continued from the operating theatre for at least 3 hours) -non-invasive mechanical ventilation (use of continuous positive airway pressure) -reintubation -use of high-flow nasal oxygen therapy Optiflow) -pneumothorax requiring (new) chest tube insertion or repositioning chest tube -need for bronchoscopy -bleeding requiring intervention (requiring surgery or transfusion of blood (clotting) products) -reoperation -supraventricular arrhythmia (new-onset atrial fibrillation or atrial flutter) with hemodynamic impairment -congestive heart failure (pleural effusion or pulmonary edema requiring diuretic therapy) -myocardial infarction (elevated hs-cTn in combination with clinical symptoms or electrocardiography changes) -hemodynamic instability requiring the use of vasopressors or inotropes | — |
Secondary
| Measure | Time frame |
|---|---|
| -pneumonia (purulent sputum, positive sputum or blood culture and clinical symptoms such as cough, fever or consolidation on chest radiograph) -pulmonary empyema (pleural effusion and the presence of pus on pleural aspiration, microorganism on pleural fluid culture or positive pleural fluid Gram stain) -sepsis (qSOFA score ≥2 in response to an infection) -wound infection (purulent drainage from superficial incision or deliberate opening of superficial incision by surgeon and pain, tenderness, swelling or redness) -urinary tract infection (urinary tract symptoms or fever and urine culture with no more than 2 species of organisms identified with at least one of which is a bacterium of ≥105 CFU/ml) -acute kidney injury (increase in serum creatinine by ≥ 26 µmol/l, a percentage increase in serum creatinine of more than or equal to 50% or oliguria of less than 0.5 ml/kg per hour for more than six hours within 48 hours) -respiratory insufficiency (hypoxia or hypercapnia leading to ICU (re)admission) -reoperation -supraventricular arrhythmia (new-onset atrial fibrillation or atrial flutter) -congestive heart failure (pleural effusion or pulmonary edema requiring diuretic therapy) -acute respiratory distress syndrome (defined as diffuse inflammatory lung injury (onset over 1 week or less), bilateral opacities consistent with pulmonary edema must be present and may be detected on CT or chest radiograph, PF ratio <300mmHg with a minimum of 5 cmH20 PEEP (or CPAP) must not be fully explained by cardiac failure or fluid overload -pulmonary embolus (filling defect ≥ 75% in a pulmonary artery with corresponding normal ventilation -stroke (clinical diagnosis of acute transient ischemic attack (TIA) or cerebrovascular accident (CVA)) -myocardial infarction (elevated hs-cTn in combination with clinical symptoms or electrocardiography changes) -mortality | — |
Contacts
Public ContactThijs Rettig
Amphia Hospital
Outcome results
None listed