Preoperative thoracic CT improves risk assessment of postop mechanical ventilation: Study

Canan and colleagues' single-center retrospective study included patients who underwent preoperative thoracic CT for abdominal or pelvic surgeries requiring general endotracheal tube anesthesia between January 1, 2014, and December 31, 2018. Cases were patients who required postoperative mechanical ventilation, and both control and case-patients were matched at a 3:1 ratio based on age, sex, body mass index, chronic obstructive pulmonary disease, smoking status, and surgery type. Two radiologists reviewed the CT scans. 

In a matched case-control study of 165 patients (70 female, 95 male; mean age, 67 years; 42 cases, 123 matched controls) who underwent major abdominal or pelvic surgery, independent predictors (p<.05) of postoperative mechanical ventilation using preoperative thoracic CT included bronchial wall thickening (exhibited odds ratio [OR]=4.8), pericardial effusion (OR=5.3), shorter lung height (OR=0.8 per cm increase), and greater anteroposterior chest diameter (OR=1.2 per cm increase).

"CT features are associated with the need for postoperative mechanical ventilation following abdominal or pelvic surgery," wrote the authors. 

"Bronchial wall thickening was the only qualitative parameter involving the lung parenchyma that differed between the case and control groups for both readers, with a significantly increased need for postoperative mechanical ventilation in patients with bronchial wall thickening," the authors of this AJR article added. 

Reference:

The study titled, "Preoperative Thoracic CT Findings Associated With Postoperative Mechanical Ventilation in Patients Undergoing Major Abdominal or Pelvic Surgery: A Matched Case-Control Study," is published in the American Journal of Roentgenology.