Journal article
What are the optimum components in a care bundle aimed at reducing postoperative pulmonary complications in high-risk patients?
Perioperative medicine (London), v 7, 7
17 Apr 2018
PMID: 29692886
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Post-operative pulmonary complications (POPC) are common, predictable and associated with increased morbidity and mortality, independent of pre-operative risk. Interventions to reduce the incidence of POPC have been studied individually, but the use of a care bundle has not been widely investigated. The purpose of our work was to use Delphi consensus methodology and an independently chosen expert panel to formulate a care bundle for patients identified as being at high of POPC, as preparation towards an evaluation of its effectiveness at reducing POPC.
Methods: We performed a survey of members of the ESICM POIC section to inform a Delphi consensus and to share their opinions on a care bundle to reduce POPC, the POPC-CB. We formed a team of 36 experts to participate in and complete an email-based Delphi consensus over three rounds, leading to the formulation of the POPC-CB.
Results: The survey had 362 respondents and informed the design of the Delphi consensus. The Delphi consensus resulted in a proposed POPC-CB that incorporates components before surgery-supervised exercise programmes and inspiratory muscle training, during surgery, low tidal volume ventilation with individualised PEEP (positive end-expiratory pressure), use of routine monitoring to avoid hyperoxia and efforts made to limit neuromuscular blockade, and post-operatively, deep breathing exercises and elevation of the head of the bed.
Conclusion: A care bundle has been suggested for evaluation in surgical patients at high risk of POPC. Evaluation of feasibility of both implementation and effectiveness is now indicated.
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Details
- Title
- What are the optimum components in a care bundle aimed at reducing postoperative pulmonary complications in high-risk patients?
- Creators
- Sophie V. Griffiths - University of SouthamptonDaniel H. Conway - Cent Manchester Fdn Trust, Dept Anaesthesia & Crit Care, Manchester M13 9WL, Lancs, EnglandMichael Sander - Universitätsklinikum Gießen und MarburgIb Jammer - Haukeland University HospitalMichael P. W. Grocott - NIHR Southampton Biomedical Research CentreBen C. Creagh-Brown - Intens (Czechia)POPC-CB Investigators
- Publication Details
- Perioperative medicine (London), v 7, 7
- Publisher
- Springer Nature
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000430829300001
- Other Identifier
- 991021448033604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Anesthesiology
- Surgery