Postoperatif pnömoni: Etyoloji ve klinik bulgular

Günümüzde gelişen teknoloji ve artan bilgi birikimine karşın, büyük ameliyatlardan sonra pnömoni gelişme oranı değişmemiştir. Yüksek mortalite ve morbidite ile seyredebilen postoperatif pnömoni gelişmesini kolaylaştırabilen çeşitli risk faktörleri vardır. Bu yazıda risk faktörlerine değinilmiş ve klinik bulgular ve tanı yöntemleri anlatılmıştır. *25.ANKEM Antibiyotik ve Kemoterapi Kongresi, Yatay İnteraktif Kurs 1A sunularından (28 Nisan-02 Mayıs 2010, Kuzey Kıbrıs Türk Cumhuriyeti)

Postoperative pneumonia: Etiology and clinical findings

The many advances of modern surgical care over the years have not appreciably altered the incidence of postoperative pneumonia after major surgery. Many risk factors have been shown to contribute to this problem and it remains as the most important cause of postoperative morbidity and mortality. Risk factors, clinical findings and diagnosis of postoperative pneumonia are revieved in this article.

PDF

___

1. Bágyi K, Haczku A, Márton I et al: Role of pathogenic oral flora in postoperative pneumonia following brain surgery, BMC Infect Dis 2009;9:104.
2. Brooks-Brunn JA: Predictors of postoperative complications following abdominal surgery, Chest 1997;111(3):564-71.
3. Dembinski R, Rossaint R: Ventilator-associated pneumonia, Anaesthesist 2008;57(8):825-42.
4. Eber MR, Laxminarayan R, Perencevich EN, Malani A: Clinical and economic outcomes attributable to health care-associated sepsis and pneumonia, Arch Intern Med 2010;170(4):347-53.
5. Efrati S, Deutsch I, Antonelli M, Hockey PM, Rozenblum R, Gurman GM: Ventilator-associated pneumonia: current status and future recommendations, J Clin Monit Comput 2010;24(2):161-8.
6. Fujita T, Sakurai K: Multivariate analysis of risk factors for postoperative pneumonia, Am J Surg 1995;169(3):304-7.
7. Hall JC, Tarala RA, Hall JL, Mander J: A multivariate analysis of the risk of pulmonary complications after laparotomy, Chest 1991;99(4):923-7.
8. Lawrence VA, Hilsenbeck SG, Mulrow CD, Dhanda R, Sapp J, Page CP: Incidence and hospital stay for cardiac and pulmonary complications after abdominal surgery, J Gen Intern Med 1995;10(12):671-8.
9. McAlister FA, Bertsch K, Man J, Bradley J, Jacka M: Incidence of and risk factors for pulmonary complications after nonthoracic surgery, Am J Respir Crit Care Med 2005;171(5):514-7.
10. Pedersen T: Complications and death following anaesthesia. A prospective study with special reference to the influence of patient-, anaesthesia-, and surgery-related risk factors, Dan Med Bull 1994;41(3):319-31.
11. Pelosi P, Jaber S: Noninvasive respiratory support in the perioperative period, Curr Opin Anaesthesiol 2010;23(2):233-8.
12. Safdar N, Dezfulian C, Collard HR, Saint S. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review, Crit Care Med 2005;33(10):2184-93.
13. Singh N, Rogers P, Atwood CW et al: Short-course empiric antibiotic therapy for patients with pulmonary infiltrates in the intensive care unit, Am J Respir Crit Care Med 2000;162(2 Pt 1):505-11.
14. Windsor JA, Hill GL: Risk factors for postoperative pneumonia. The importance of protein depletion, Ann Surg 1988;208(2):209-14.