Perioperative Factors Influencing the Incidence of Postoperative Pulmonary Complications in Patients Undergoing Head-and-Neck versus Abdominal Surgeries and their Outcome

IntRoductIonPostoperative pulmonary complications (PPCs) are not uncommon after prolonged surgeries that affect the patient outcome adversely and increase hospital stay and utilization of resources.The incidence of PPCs which are heterogeneous depends on its definition and varies in different surgical categories.Even mild PPCs can be associated with increased early mortality and would need special attention for improving the outcome.[1] Identification and optimization of the risk factors are important to reduce or prevent PPCs and to minimize premature deaths in patients undergoing surgery.[2,3] The risk factors for PPCs are identified in multiple studies, and various predictive factors have been recognized in LAS VEGAS risk scoring and by the validated ARISCAT scoring.[4,5] The level of risk of surgery, duration of surgery, volume of intraoperative fluids, inotropic support, and neuromuscular blocking agents used are identified to be associated with PPCs.[4][5][6][7][8] Currently, major prolonged surgeries are often performed that would need postoperative ventilation for various reasons.Balanced anesthesia techniques are used with neuromuscular blocking agents, fluids, blood transfusions, and inotropic support as part of standard care.Their needs are often inevitable though some of them are modifiable.