PREVENTION OF PULMONARY COMPLICATIONS IN THORACIC ANESTHESIOLOGY

Introduction. Pulmonary complications are one of the most common after surgery on the thoracic cavity. Although the incidence of pulmonary complications is gradually decreasing, recent studies have shown that they still occur in 26% -38% of cases. Pulmonary complications are also a major cause of hospital mortality and may be an independent risk factor for worse long-term survival [1, 2, 3]. The goal of the work. Therefore, the aim of the work was to improve the results of treatment of patients after thoracic surgery by developing an algorithm for anesthesia for perioperative prevention of pulmonary complications. Materials and methods. The study was performed on 192 patients with diseases of the thoracic cavity (esophagus, lungs, mediastinum), underwent surgery in the thoracoabdominal department of the Shalimov’s National Institute of Surgery and Transplantation. Retrospective control group – 96 patients after thoracic surgery, which used conventional methods of perioperative management. The study group – 96 patients after thoracic surgery, which used perioperative anesthesia algorithm for the prevention of pulmonary complications. Statistical software EZR v. 1.54 was used for statistical calculations (graphical user interface for statistical software R version 4.0.3, R Foundation for Statistical Computing, Vienna, Austria). Results and discussion. One-factor analysis revealed a relationship (p = 0.001) of the risk of complications with the method of prevention of pulmonary complications. When conducting a multifactor analysis, it was found that the proposed method of prevention of pulmonary complications can reduce (p = 0.001) the risk of development, HR = 0.27 (95% CI 0.13-0.58) compared with the control group (with standardization by sex, weight, ASA of the patient). Pulmonary complications developed in 33 (34.4%) patients of the control group and in 13 (13.5%) patients of the study group, the difference was statistically significant, p = 0.001. Thus, the use of the proposed technique reduces (p = 0.001) the risk of complications, HR = 0.39 (95% CI 0.22 - 0.70) compared to traditional methods. Conclusions. Thus, the developed algorithm for the prevention of pulmonary complications after thoracic surgery has significantly improved the results of surgical treatment of patients by reducing the number and reducing the risk of these complications by 2.5 times (from 34.4% in patients in the control group to 13.5% in patients in the study group).