title: Adverse respiratory events in a post-anesthesia care unit.
abstract: BACKGROUND
  Adverse respiratory events (ARE) are a leading causes of postoperative morbidity and mortality. This study investigated the incidence and determinants of postoperative ARE.
  
  
  METHODS
  This observational prospective study was conducted in a post anesthesia care unit (PACU). A total of 340 adult subjects were admitted consecutively, and AREs were measured after elective surgery. Population demographics, perioperative parameters, ARE occurrence, and length of stay in the postoperative PACU and in hospital were recorded. Data were analyzed descriptively using the Mann-Whitney U-test and the Chi-square or Fisher's exact test. Multivariate analyses were carried outusing logistic binary regression, and the odds ratio (OR) and 95% confidence interval (CI) were calculated.
  
  
  RESULTS
  Postoperative AREs occurred in 67 subjects (19.7%). AREs were more frequent after high-risk procedures (42% vs 24%; P=.003), in patients undergoing major surgery (37% vs 25%; P=.041), those receiving general anesthesia (85% vs 67%; P=.004), and in patients administered intraoperative muscle relaxants (79% vs 55%; P<.001) and neostigmine (69% vs 49%; P=.002). Hypoactive emergence (13% vs 5%; P=.015) and residual neuromuscular blockade (46% versus 11%; P<.001) were more frequent in subjects with postoperative ARE. On multivariate analyses, residual neuromuscular blockade was an independent risk factor for ARE in the PACU (OR 6.4; CI 3.0-13.4; P<.001).
  
  
  CONCLUSIONS
  ARE is an important and common postoperative complication. Residual neuromuscular blockade was an independent risk factor for ARE in the PACU.
authors: Department of Anesthesia, Post-Anesthesia Care Unit, Centro Hospitalar São João, Oporto, Portugal.
authors: Daniela
authors: D
authors: Xará
authors: Department of Anesthesia, Post-Anesthesia Care Unit, Centro Hospitalar São João, Oporto, Portugal.
authors: Alice
authors: A
authors: Santos
authors: Department of Anesthesia, Post-Anesthesia Care Unit, Centro Hospitalar São João, Oporto, Portugal; Faculty of Medicine, University of Porto, Oporto, Portugal. Electronic address: fernando.abelha@gmail.com.
authors: Fernando
authors: F
authors: Abelha
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000453:epidemiology; D000762:Anesthesia Recovery Period; D000886:Anthropometry; D055191:Delayed Emergence from Anesthesia / Q000453:epidemiology; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage / Q000009:adverse effects; D010102:Oxygen Inhalation Therapy; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D011997:Recovery Room; D012120:Respiration Disorders / Q000453:epidemiology*; D012128:Respiratory Distress Syndrome / Q000453:epidemiology
chemical_list: D009466:Neuromuscular Blocking Agents
keywords: Cuidados postoperatorios; Episodios respiratorios; Outcome; Postoperative care; Respiratory events; Resultados clínicos