Imperial College London
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ProfessorNickHopkinson

Faculty of Medicine, National Heart & Lung Institute

Professor of Respiratory Medicine
 
 
 
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Contact

 

n.hopkinson

 
 
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Location

 

Muscle LabSouth BlockRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Lee:2021:10.1111/anae.15187,
author = {Lee, AHY and Snowden, CP and Hopkinson, N and Pattinson, KTS},
doi = {10.1111/anae.15187},
journal = {Anaesthesia},
pages = {681--694},
title = {Pre-operative optimisation for chronic obstructive pulmonary disease},
url = {http://dx.doi.org/10.1111/anae.15187},
volume = {76},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Chronic obstructive pulmonary disease is a condition commonly present in older people undergoing surgery and confers an increased risk of postoperative complications and mortality. Although predominantly a respiratory disease, it frequently has extrapulmonary manifestations and typically occurs in the context of other longterm conditions. Patients experience a range of symptoms that affect their quality of life, functional ability and clinical outcomes. In this review, we discuss the evidence for techniques to optimise the care of people with chronic obstructive pulmonary disease in the perioperative period, and address potential new interventions to improve outcomes. The article centres on pulmonary rehabilitation, widely available for the treatment of stable chronic obstructive pulmonary disease, but less often used in a perioperative setting. Current evidence is largely at high risk of bias, however. Before surgery it is important to ensure that what have been called the ‘five fundamentals’ of chronic obstructive pulmonary disease treatment are achieved: smoking cessation; pulmonary rehabilitation; vaccination; selfmanagement; and identification and optimisation of comorbidities. Pharmacological treatment should also be optimised, and some patients may benefit from lung volume reduction surgery. Psychological and behavioural factors are important, but are currently poorly understood in the perioperative period. Considerations of the risk and benefits of delaying surgery to ensure the recommended measures are delivered depends on patient characteristics and the nature and urgency of the planned intervention.
AU  - Lee,AHY
AU  - Snowden,CP
AU  - Hopkinson,N
AU  - Pattinson,KTS
DO  - 10.1111/anae.15187
EP  - 694
PY  - 2021///
SN  - 0003-2409
SP  - 681
TI  - Pre-operative optimisation for chronic obstructive pulmonary disease
T2  - Anaesthesia
UR  - http://dx.doi.org/10.1111/anae.15187
UR  - http://hdl.handle.net/10044/1/81065
VL  - 76
ER  -
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