|
| European perioperative clinical outcome (EPCO) definitions of postoperative pulmonary complications [18] |
| Respiratory infection | Patient has received antibiotics for suspected respiratory infection and met one or more of the following criteria: new or changed sputum, new or changed lung opacities, fever, white blood cell count > 12 × 109/litre |
| Respiratory failure | Postoperative PaO2 < 60 mm·Hg on room air, PaO2 : FiO2 ratio < 300 mm·Hg), or arterial oxyhaemoglobin saturation measured with pulse oximetry < 90% and needing oxygen therapy |
| Pleural effusion | Chest radiograph showing blunting of costophrenic angle, loss of sharp silhouette of ipsilateral hemidiaphragm in upright position, evidence of displacement of adjacent anatomical structures, or (in supine position) hazy opacity in one hemithorax with preserved vascular shadows |
| Atelectasis | Lung opacification with shift of mediastinum, hilum, or hemidiaphragm towards affected area, and compensatory over-inflation in adjacent nonatelectatic lung |
| Pneumothorax | Air in pleural space with no vascular bed surrounding visceral pleura |
|
| Assess respiratory risk in surgical patients in catalonia (ARISCAT) score for risk prediction of postoperative pulmonary complications [17] |
| Risk factor | Score |
| Age 51–80 | 3 |
| Age > 80 | 16 |
| Preoperative SpO2 91–95% | 8 |
| Preoperative SpO2 ≤ 90% | 24 |
| Respiratory infection in past 1 month | 17 |
| Preoperative haemoglobin < 10 gm/dl | 11 |
| Upper abdominal incision | 15 |
| Intrathoracic incision | 24 |
| Surgery duration 2-3 hours | 16 |
| Surgery duration > 3 hours | 23 |
| Emergency procedure | 8 |
| Total score-low risk: <26, intermediate risk: 26–44, high risk: ≥45 |
|
| Apfel score for risk prediction of PONV [20] |
| Risk factors (1 point each) – female sex, history of ponv or motion sickness, nonsmoker, postoperative opioid treatment planned. |
| Total score and risk stratification |
| 0 | Minimal risk |
| 1 | Low risk |
| 2 | Intermediate risk |
| 3 | High risk |
| 4 | Very high risk |
|
| Definitions of postoperative care unit events |
| PACU events |
| (i) Any desaturation to SpO2 < 90% | |
| (ii) Need for manual airway support | |
| (iii) Need for oropharyngeal or nasopharyngeal airway | |
| (iv) Need for reintubation in PACU | |
| (v) Need for anaesthetist to review the patient | |
| (vi) Unplanned ICU admission | |
| PONV score |
| 1. No PONV | |
| 2. PONV responsive to antiemetics | |
| 3. PONV unresponsive to antiemetics | |
|
