A cross-sectional survey of perioperative lung protection in gastrointestinal surgery in Mainland China

Objective: To understand the implementation status of perioperative lung protection (PLP) in gastrointestinal surgery patients and the awareness of PLP and respiratory care (RC) among gastrointestinal surgeons in Mainland China.Methods: Taking the hospital of the investigator as the initiating unit, the questionnaire was distributed to gastrointestinal surgeons, intensive care unit doctors, and respiratory therapists (RTs) of hospitals in Chinese Mainland in the form of WeChat questionnaires. The investigation was divided into two rounds: preliminary screening and return visit.Results: A total of 157 valid questionnaires were collected, including 89 hospitals in 24 provinces, autonomous regions, and municipalities in Mainland China. Thirty-two hospitals did not have RTs. In the 57 (64%) of 89 hospitals with RTs, there were 26 (57%) hospitals with RTs number of 2 or less, only 6 hospitals had full-time RTs, 33 (59%) of 56 hospitals had no more than 2 RTs with over 3 years working experience, and perioperative patients of gastrointestinal surgery in only 9 (16%) of 57 hospitals often received help from RTs. A total of 60 gastrointestinal surgeons were surveyed, among which 23 (38%) answered that they knew nothing about RC, 44 (73%) considered gastrointestinal surgery patients should receive RC, and 57 (95%) considered their hospitals should set up RC department. Three main resistance sources of RC development of gastrointestinal surgery from high to low were insufficient attention of leaders (67%), human resources' shortage (57%), and charging too cheaply or even without related services' charges (48%).Conclusions: In Chinese Mainland, patients with gastrointestinal surgery were seriously lack of PLP support, and gastrointestinal surgeons lack awareness of RC. We appeal to pay more attention to PLP in gastrointestinal surgery patients and promote perioperative safety.