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Canadian Respiratory Journal
Volume 2016 (2016), Article ID 3981506, 6 pages
http://dx.doi.org/10.1155/2016/3981506
Research Article

Who Needs to Be Allocated in ICU after Thoracic Surgery? An Observational Study

Respiratory Division, Universidade Federal de São Paulo (UNIFESP), 04023-062 São Paulo, SP, Brazil

Received 24 February 2016; Accepted 23 June 2016

Academic Editor: Alberto Ruano-Ravina

Copyright © 2016 Liana Pinheiro et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The effective use of ICU care after lung resections has not been completely studied. The aims of this study were to identify predictive factors for effective use of ICU admission after lung resection and to develop a risk composite measure to predict its effective use. Methods. 120 adult patients undergoing elective lung resection were enrolled in an observational prospective cohort study. Preoperative evaluation and intraoperative assessment were recorded. In the postoperative period, patients were stratified into two groups according to the effective and ineffective use of ICU. The use of ICU care was considered effective if a patient experienced one or more of the following: maintenance of controlled ventilation or reintubation; acute respiratory failure; hemodynamic instability or shock; and presence of intraoperative or postanesthesia complications. Results. Thirty patients met the criteria for effective use of ICU care. Logistic regression analysis identified three independent predictors of effective use of ICU care: surgery for bronchiectasis, pneumonectomy, and age ≥ 57 years. In the absence of any predictors the risk of effective need of ICU care was 6%. Risk increased to 25–30%, 66–71%, and 93% with the presence of one, two, or three predictors, respectively. Conclusion. ICU care is not routinely necessary for all patients undergoing lung resection.