Surgery Book


  • Preoperative Respiratory Risk Modification


Preoperative Respiratory Risk Modification

Aka: Preoperative Respiratory Risk Modification, Preoperative COPD Risk Modification, Preoperative Sleep Apnea Risk Modification, Perioperative Pulmonary Risk Modification
  1. See Also
    1. Preoperative Pulmonary Risk Stratification
    2. Preoperative Examination
    3. Preoperative Cardiovascular Evaluation
    4. Preoperative Evaluation in Kidney Disease
    5. Perioperative Beta Blocker
    6. Antiplatelet Therapy for Vascular Disease
    7. Perioperative Cardiovascular Risk
    8. Perioperative Diabetes Management
    9. Deep Vein Thrombosis Prevention
    10. Perioperative Anticoagulation
    11. Endocarditis Prophylaxis
    12. Postoperative Nausea and Vomiting Prevention
    13. Perioperative Corticosteroid
    14. Preoperative Guidelines for Medications Prior to Surgery
  2. Management: COPD - Perioperative Pulmonary Risk Reduction
    1. Assess Preoperative Pulmonary Risk Stratification
      1. Consider delaying or canceling surgery when pulmonary risk exceeds potential surgical benefit
    2. Optimize COPD Management
    3. Manage acute lung disease prior to surgery
    4. Optimize Nutritional Status
      1. Serum Albumin <3.5 g/dl is most predictive marker of pulmonary risk
    5. Consider Pulmonary RehabilitationConsultation
    6. Consider Stress Dose Steroids
    7. Tobacco Cessation
      1. Always recommend (but does not impact immediate surgery risk)
  3. Management: Sleep Apnea
    1. Bring CPAP machine to hospital on day of surgery
    2. Close monitoring with Anesthesia and sedation due to increased airway associated risks
  4. References
    1. Dummer (2009) Perioperative Guideline Review
    2. Qaseem (2006) Ann Intern Med 144(8):575-80 [PubMed]

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