Preventing Postoperative Pulmonary Complications in Patients Undergoing Noncardiac Surgery

Postoperative pulmonary complications (PPCs) — especially common in elders and patients who undergo surgery near or involving the thorax — include respiratory failure, infection, atelectasis, effusion, and pneumothorax. In this systematic review and meta-analysis of 95 randomized trials (18,000 adult patients; mainly involving abdominal or thoracic surgeries and excluding cardiac surgery), researchers assessed the efficacy of various interventions for preventing PPCs.

In all but one trial, participants received general anesthesia with or without adjunctive regional anesthesia. PPCs occurred in 14% of participants. The following seven interventions (each listed with its relative risk reduction [RRR] and estimated number needed to treat [NNT])…