Postoperative care after pulmonary resection: postanesthesia care unit versus intensive care unit.
OBJECTIVE
In an effort to maximize resource utilization and contain costs, immediate postoperative care after noncardiac thoracic surgery is often done in either the postanesthesia care unit or dedicated step down units, leaving the ICU for complex surgical cases, overtly high-risk patients, or the treatment of severe postoperative complications. This review analyzes the current modalities affecting length of stay and costs, mainly by allocating patients after elective lung resection to different postoperative areas according to their needs.


RESULTS
Several surgical models have been published in recent years with the goal of optimizing perioperative patient care and subsequently decreasing hospital costs and length of stay. The main focus has been on elective lung resection for lung cancer. Preoperative evaluation, changes in surgical and anesthetic techniques as well as careful planning on where to recover these patients seem to make a clinical and financial impact.


CONCLUSIONS
The development of models to help predict elective ICU admission should facilitate optimal care, cutting costs and shortening length of stay after lung resection.
Pedoto
Alessia
A
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, USA. pedotoa@mskcc.org
Heerdt
Paul M
PM
D000758:Anesthesia; D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D008168:Lung / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control / Q000628:therapy*; D011300:Preoperative Care; D012307:Risk Factors