How can we minimize the risks by optimizing patient & #39;s condition shortly before thoracic surgery ?

Christoph Ellenberger, Raoul Schorer, Benoit Bedat, Andres Hagerman, Frederic Triponez, Wolfram Karenovics, Marc LickerSaudi Journal of Anaesthesia 2021 15(3):264-271 The “moderate-to-high-risk” surgical patient is typically older, frail, malnourished, suffering from multiple comorbidities and presenting with unhealthy life style such as smoking, hazardous drinking and sedentarity. Poor aerobic fitness, sarcopenia and “toxic” behaviors are modifiable risk factors for major postoperative complications. The physiological challenge of lung cancer surgery has been likened to running a marathon. Therefore, preoperative patient optimization or “ prehabilitation “ should become a key component of improved recovery pathways to enhance general health and physiological reserve prior to surgery. During the short preoperative period, the patients are more receptive and motivated to adhere to behavioral interventions (e.g., smoking cessation, weaning from alcohol, balanced food intake and active mobilization) and to follow a structured exercise training program. Sufficient protein intake should be ensured (1.5–2 g/kg/day) and nutritional defects should be corrected to restore muscle mass and strength. Currently, there is strong evidence supporting the effectiveness of various modalities of physical training (endurance training and/or respiratory muscle training) to enhance aerobic fitness and to mi...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research