title: Predictors of postoperative pulmonary complications after liver resection: Results from a tertiary care intensive care unit.
abstract: BACKGROUND
  Postoperative pulmonary complication (PPC) is a serious complication after liver surgery and is a major cause of mortality and morbidity in the intensive care unit (ICU). Therefore, the early identification of risk factors of PPCs may help to reduce the adverse outcomes.
  
  
  OBJECTIVE
  The aim of this retrospective study was to determine the predictors of PPCs in patients undergoing hepatic resection.
  
  
  METHODS
  Retrospective, observational.
  
  
  METHODS
  The patients admitted after hepatic resection in the gastrosurgical ICU of our institute between October 2009 and June 2013 was identified. The ICU charts were retrieved from the database to identify patients who developed PPCs. A comparison of risk factors was made between the patients who developed PPC (PPC group) against the patients who did not (no-PPC group).
  
  
  RESULTS
  Of 117 patients with hepatic resection, 28 patients developed PPCs. Among these, pneumonia accounted for 12 (42.8%) followed by atelectasis in 8 (28.5%) and pleural effusion in 3 (10.7%). Among the patients developing PPCs, 16 patients were over a 70-year-old (57.1%), 21 patients were smokers (75%) and 8 patients (28.5%) had chronic obstructive pulmonary disease (COPD). The requirement for blood transfusion and duration of mechanical ventilation were greater in the patients developing PPC (2000 ± 340 vs. 1000 ± 210 ml; 10 ± 4.5 vs. 3 ± 1.3 days).
  
  
  CONCLUSIONS
  Old age, chronic smoking, COPD, increased blood product transfusion, increased duration of mechanical ventilation and increased length of ICU stay increased the relative risk of PPC, presence of diabetes and occurrence of surgical complications (leak, dehiscence, etc.) were independent predictive variables for the development of PPC.
authors.affiliation: Department of Anesthesiology and Intensive Care, GB Pant Hospital, New Delhi, India.
authors.forename: Anirban Hom
authors.initials: AH
authors.lastname: Choudhuri
authors.affiliation: Department of Anesthesiology and Intensive Care, GB Pant Hospital, New Delhi, India.
authors.forename: Som
authors.initials: S
authors.lastname: Chandra
authors.affiliation: Department of Anesthesiology and Intensive Care, GB Pant Hospital, New Delhi, India.
authors.forename: Garima
authors.initials: G
authors.lastname: Aggarwal
authors.affiliation: Department of Anesthesiology and Intensive Care, GB Pant Hospital, New Delhi, India.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Uppal
keywords: Hepatic resection; posthepatic resection complications; postoperative pulmonary complications