Risks of long term intensive care after thoractomy.

概要

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During the five-year period between January 1, 1983 and December 31, 1987, 712 patients were operated upon for thoracic and cardiovascular diseases. Median sternotomy was used for cardiovascular surgery, and 294 thoracotomies were performed for lung cancer, esophageal cancer, etc. Of these 294 patients, 33 (11.2%) remained in our Intensive Care Unit (ICU) for 10 or more days postoperatively. The incidence of postoperative pneumoniae was 52%. The pathogenic organisms were mainly Pseudomonas aeruginosa, Klebsiella pneumoniae and Staphylococcus aureus. Nine of those 33 patients (27%) died in the ICU; four of them had lung cancer, three had esophageal cancer and two had other diagnoses. Preoperative risk factors in these patients were cigarette smoking, respiratory hypofunction, low A/G ratio, low performance status, hypertension and diabetes mellitus. We conclude that it is very important to determine preoperative risk factor as well as to provide postoperative intensive care.
特定非営利活動法人日本呼吸器外科学会の論文