Aetiology, management and strategies for prevention of postoperative respiratory failure (PORF) after thoracic surgery

Post-operative pulmonary complications (PPCs) occur in a large proportion of patients after thoracic surgery and are associated with higher rates of morbidity and mortality. Avoidance of PPCs can be achieved through a multi-disciplinary and multifactorial approach which addresses a number of preoperative, intra-operative and post-operative factors. A subgroup of patients who develop PPCs will progress to post-operative respiratory failure (PORF). Treatment strategies for these patients all have the underlying aim of avoiding the need for re-intubation, which is associated with extremely high mortality. This review considers the aetiology, management and strategies for prevention of PORF after thoracic surgery.