title: Adult respiratory distress syndrome after microvascular free tissue reconstruction in head and neck malignancy.
abstract: Adult respiratory distress syndrome (ARDS) is an important cause of morbidity and mortality after major operations. We undertook a 10 year retrospective analysis of patients undergoing major surgery in combination with microvascular free tissue transfer for head and neck malignancy at a Regional Maxillofacial Unit to try and identify predisposing factors. In the 10 year period to 31 April 1995, roughly 418 patients underwent major head and neck reconstructions, of which 399 (95.5%) were admitted to the intensive care unit (ICU) postoperatively. Thirty patients (7.2%) spent more than 72 h in the ICU, eight developed ARDS (1.9%) of whom four died. The factors that seemed to contribute to the development of ARDS were massive blood transfusion and early postoperative complications that required a further operation under general anaesthesia.
authors.affiliation: Shackleton Department of Anaesthesia, Southampton General Hospital, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Logan
authors.forename: S N
authors.initials: SN
authors.lastname: Rogers
authors.forename: D
authors.initials: D
authors.lastname: Richardson
authors.forename: E D
authors.initials: ED
authors.lastname: Vaughan
authors.forename: J S
authors.initials: JS
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012086:Reoperation / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps / Q000009:adverse effects* / Q000098:blood supply; D065227:Transfusion Reaction