Pneumonia After Thoracic Surgery

Abstract

The most frequent and severe complication after thoracic surgery is pneumonia. Hypoventilation due to pain and insufficient cough is the reason for postoperative pneumonia after thoracic surgery. There is a risk index developed from preoperative patients and operation-specific risk factors. The risk index may be useful for high-risk patients; therefore giving these patient groups more attention in the perioperative period and taking preventive measures may reduce the incidence of pneumonia. Postoperative period composed of pulmonary rehabilitation and analgesia includes breathing exercise, cough training, self-management education, and psychosocial support, and they have been shown to decrease complications. According to some new studies, paravertebral block has similar analgesic effects with thoracic epidural analgesia (TEA). Although paravertebral block has fewer adverse effects, TEA is still the gold standard for pain relief after thoracotomies. The incidence of pneumonia varies in the literature because there is no gold standard for the diagnosis of postoperative pneumonia. Many centers use only clinical criteria, whereas others use invasive diagnostic techniques. Empirical antibiotic treatment should be started based on patient factors, local infection, and susceptibility patterns.