RESPIRATORY CARE TO PREVENT COMPLICATIONS AFTER THORCOTOMY Essay

RESPIRATORY CARE TO PREVENT COMPLICATIONS AFTER THORCOTOMY - Essay Example Up to 65% of patients may have an atelectasis, and 3% may develop pneumonia (Pasquina et al 2003). They are the result of progressive changes in the respiratory status of the patient and play a significant role in postoperative morbidity and mortality (Leo et al 2006). They also prolong hospital stay and increase healthcare costs (Pasquina et al 2003). Thoracotomy is performed for various surgeries like resection of pulmonary and esophageal tumors, operations on the lung like pneumonectomy, lobectomy, segmental resection, wedge resection and lung-volume reduction surgery, operations on the pleura like pleurectomy and decortication, operations on the esophagus and on the heart (Porter 2003). The pulmonary complications are usually delayed, occurring 48–72 hours after thoracotomy (Leo et al 2006). The commonly seen complications are adult respiratory distress syndrome, pneumonia, atelectasis, pulmonary embolism, pulmonary edema, asthma and respiratory failure (Leo et al 2006). Since pulmonary complications increase the morbidity and mortality of patients following surgery, many studies have been done to look into means of preventing these complications. Leo et al (2006) evaluated the benefits of identifying these complications early in the course of post-operative care after thoracotomy, so that appropriate interventions can be delivered to prevent and manage these complications. They used a multifactorial score called FLAM score to identify postoperative patients at higher risk for pulmonary complications at least 24 hours before the clinical diagnosis. The FLAM score was based on 7 parameters, namely, dyspnea, chest X-ray, delivered oxygen, auscultation, cough, quality and quantity of bronchial secretions. The researchers concluded that changes in FLAM score could be detected atleast 24 hours before the clinical diagnosis of pulmonary complications, giving as opportunity for the clinicians to take action much before overt symptoms. Algar et al