Background: Postoperative pulmonary complications (PPC) are important problems that prolong hospital stays by increasing morbidity and mortality of patients. Early identification of risky cases through preoperative evaluation is important for reducing the complications that may be seen in patients Postoperatively. The aim of this study is to calculate, evaluate and compare the risk indices for PPC in patients who will undergo elective abdominal surgery. Materials and Methods: One hundred twenty-four patients who were hospitalized for elective abdominal surgery were included in this prospective observational study. American Society of Anesthesiologists (ASA), Epstein and Shapiro scores, respiratory failure index (RFI), pneumonia risk indexes (PI) and scores were calculated preoperatively. Patients were re-evaluated at the 48th Postoperative hour, and one-week follow-up was performed. The patients with PPCs are recorded. Results: The mean PPC rate was 36. 8%. Based on this, pleural effusion was observed in 18. 5%, prolonged mechanical ventilation in 8. 9%, atelectasis in 9. 7%, and respiratory failure in 5. 7%, bronchospasm in 4. 0%, and pneumonia in 3. 2% of patients. An increased risk in PPC was determined if ASA were above 3 (odds ratio, [OR], 7. 06,<0. 001), PI scores were above 3 (OR, 6. 67,<0. 001), RFI score were above 4 (OR, 6. 30, p: 0. 001) and Shapiro score above 2 (OR, 20. 01,<0. 001), respectively. Conclusion: The Shapiro index is the strongest predictor of pulmonary complications, whereas the PI is the strongest predictor of morbidity risk. However, RFI and the PI are equally valuable for predicting respiratory complications and may prove to be useful in abdominal surgeries for preoperative assessment.

The main goal of this report was to share with clinicians an atypical presentation of pulmonary thromboembolism (PTE) in a young male's post-appendectomy, whom he had no significant predisposing factors for such disease. The case also introduced for re-examining the challenges of PTE clinical manifestations which may mimic other differential diagnosis.PTE is an abrupt blockage of the pulmonary artery by a thrombus. Such thrombus is generated by a blood clot which has been formed, separated and migrated from the leg and/or pelvic veins toward the lung. The lung tissue's circulation is impaired which later episode results hypoxia and infarction. These events initiate a set of PTE clinical manifestations.

Introduction: After abdominal surgery, the patients who are separated from mechanical ventilation and provided with oxygen therapy via a T-piece are at risk for respiratory complications. Therefore, they need additional respiratory support. This study aimed to evaluate the effects of manual hyperinflation (MHI) on pulmonary function after weaning. Methods: This randomized clinical trial included 40 patients who had undergone abdominal surgery and were receiving oxygen via a T-piece. Patients were selected from the intensive care units (ICU) of two hospitals in Mashhad, Iran. The subjects were randomly allocated to intervention (MHI) and control groups. Patients in the MHI group were provided with three 20-minute MHI rounds using the Mapleson C, while the control group received routine cares. Tidal volume (Vt), Rapid Shallow Breathing Index (RSBI), and the ratio of arterial oxygen partial pressure to fractional inspired oxygen (P/F ratio) were measured before the intervention, as well as 5 and 20 minutes after the intervention. Atelectasis prevalence was assessed before and 24 hours after the intervention. Data were analysed by SPSS software version 13. Results: At baseline, there were no significant differences between the groups regarding Vt, RSBI, P/F ratio, and atelectasis rate. No significant difference was also found between the groups regarding atelectasis rate 24 hours after the intervention. However, at both posttests, Vt, RSBI, and P/F ratio in the MHI group were significantly better than the control group. Conclusion: In patients with artificial airway and spontaneous breathing, MHI improves pulmonary function.

Background: Postoperative pulmonary complications (PPCs) are among the leading causes of morbidity, mortality, and increased length of stay (LOS). Methods: In a prospective cohort study, all adult candidates for all types of open-heart surgeries were enrolled and followed from admission to discharge for PPCs. Results: The study population consisted of 918 consecutive adult patients, including 574 (62. 5%) males, at a mean age of 56. 20±, 13. 95 (mean ±,standard deviation) years who underwent open cardiac surgery. Among them, 537 patients (58. 5%) suffered PPCs, comprising pleural effusion in 293/916 (32. 0%), atelectasis in 222 (24. 2%), pneumonia in 68 (7. 4%), diaphragm paralysis in 67 (7. 3%), pulmonary edema and/or acute respiratory distress syndrome in 64/915 (7. 0%), pneumothorax (in the right or left hemithorax) in 28/916 (3. 1%), hemothorax in 7/915 (0. 8%), subcutaneous emphysema in 11/913 (1. 2%), and empyema in 2/918 (0. 2) The independent risk factors for PPCs were age (OR, 1. 010,95% CI, 1. 001 to 1. 020,P=0. 0326), female sex (OR, 1. 375,95% CI, 1. 044 to 1. 811,P=0. 0235), and renal dysfunction (OR, 1. 553,95% CI, 1. 001 to 2. 409,P=0. 0497). Twenty-three patients died within 30 days of cardiac surgery, accounting for a hospital mortality rate of 2. 5%. Conclusions: The cumulative incidence rate of PPCs was 58. 5% in our center, with a mortality rate of 3. 4%. The overall mortality rate among all the patients was 2. 5%. The independent risk factors associated with PPCs were age, female sex, and renal failure.

Introduction & Objective: The main indication of mechanical ventilation is in the treatment of neonates with respiratory failure. With the increased use of mechanical ventilation ,its complications have increased too. The aim of this study was to evaluate the prevalence of complications and short- term improvement in infants undergoing mechanical ventilation in the neonatal intensive care unit (NICU).Materials & Methods: In this prospective-analytic study ,all infants requiring mechanical ventilation and admitted in the neonatal intensive care unit of Fatemiyeh and Be’sat hospitals ,have been evaluated for one year (2012). Their data included: neonatal age ,sex ,gestational age ,birth weight ,weight at admission ,diagnosis ,length of hospitalization ,disease outcome (improvement- died) ,need for mechanical ventilation ,complications and culture results (blood ,endotracheal tube ,urine ,CSF) insert in check list. The data were analysed by SPSS and c2 statistical test.Results: In this study ,a total of 114 infants hospitalized in intensive care unit and needed mechanical ventilation was studied of whom 72 were male and 42 were female. The mean of gestational age in the admitted neonates was 32.9±0.85 weeks. The majority of neonates (80.70%) were undergoing mechanical ventilation with respiratory distress syndrome (RDS). 67% of neonates were suffering from complications of mechanical ventilation. The prevalent complication was seen in the neonates was narrowing or obstruction of the endotracheal tube (52.63%). 47.37% of infants died and respiratory distress syndrome was the common cause of death in these neonates (46.29%). In our study ,there was significant relationship between resuscitation at birth (P=0.002) ,time required for mechanical ventilation (P=0.0000) and Apgar score (P=0.0000) and complications of mechanical ventilation.Conclusions: The results show that the high prevalence of pulmonary complications is associated with mechanical ventilation and decreasing the use of invasive methods of respiratory care and reduced complications can increase the survival rate of these infants.

Background: Obstructive sleep apnea and snoring are associated with high blood pressure, stroke, and cognitive impairment, as well as increased risk of perioperative heart events and respiratory failure. Objective: This study aimed to investigate the association between snoring and pulmonary complications after coronary artery bypass graft (CABG) surgery. Materials and Methods: In this cross-sectional study, 232 participants referred to two general hospitals in Mashhad, Iran, from December 2017 to January 2018, for coronary artery bypass surgery, were categorized into two groups of snoring and non-snoring history. A checklist including demographic characteristics, snoring history, medical history, lung complications, and laboratory findings was completed for each participant. In addition, three snoring questionnaires, including STOP-BANG, Berlin, and Epworth, were filled out. Results: The results showed no statistically significant differences between the groups in terms of age (P=0. 404). Moreover, there was a significant difference in oxygen saturation, duration of extubation, and length of stay in ICU and surgery ward in the snoring group. The mean score of the snoring group was significantly high according to the Epworth scale (P=0. 001). According to the Berlin and STOP-BANG questionnaire, participants with snoring had a significant risk of apnea and obstructive sleep apnea with P=0. 008 and P=0. 001, respectively. There was no significant difference between the history of diseases, such as hypertension, diabetes, and hyperlipidemia (P>0. 05). Conclusion: conclusion: In CABG surgery patients, snoring increases the time required for extubation and the length of stay in hospital,it also decreases oxygen saturation after surgery.