Predictors of an appropriate admission to an ICU after a major pulmonary resection

Paola Pieretti, Marco Alifano, Nicolas Roche, Matteo Vincenzi, Sergio N Forti Parri, Monica Zackova, Maurizio Boaron, Marco Zanello

Research output: Contribution to journalArticle

Abstract

Background: There are no recommendations about admission to an ICU after a major lung resection and there are considerable differences among institutions in this respect. Objectives: To audit the practice of admission to an ICU after a major lung resection and evaluate factors predicting the need for intensive care. Methods: Clinical records of all patients who underwent major pulmonary resections in a 14-month period were reviewed retrospectively. The criteria for postoperative admission to the ICU were: (1) standard pneumonectomy if comorbidity index (Cl) >0 and/or ASA score >1, and/or abnormal spirometry or arterial gas analysis; (2) extended pneumonectomy; (3) lobectomy if Cl ≥4 and/or ASA ≥3; (4) lobectomy if FEV1 1 is between 60 and 80% and hypercapnia. Results: Among the 49 patients postoperatively admitted to the surgical ward, only 1 needed late intensive care. Among the 55 patients admitted to the ICU, 25 did not require specific intensive care and were discharged 24 h postoperatively, whereas the remaining 30 patients required specific intensive care. Multivariate analysis identified ASA score, predictive postoperative DLCO, and predictive postoperative product (PPP) as independent predictors of a need for admission to an ICU. Conclusion: This empirical protocol was useful in identifying patients not likely to need admission to the ICU. ASA score, predictive postoperative DLCO, and PPP are independent predictors of a need for admission to an ICU.

Original languageEnglish
Pages (from-to)157-165
Number of pages9
JournalRespiration
Volume73
Issue number2
DOIs
Publication statusPublished - Mar 2006

Keywords

  • Intensive care
  • Lung resection
  • Pulmonary function

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Physiology

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    Pieretti, P., Alifano, M., Roche, N., Vincenzi, M., Parri, S. N. F., Zackova, M., Boaron, M., & Zanello, M. (2006). Predictors of an appropriate admission to an ICU after a major pulmonary resection. Respiration, 73(2), 157-165. https://doi.org/10.1159/000088096