1. Describe the incidence of postoperative hypoxemia after major emergency abdominal surgery as well as correlate this to clinical outcomes. 2. Investigate the association between postoperative pulmonary complications and respiratory muscle dysfunction. 3. Investigate the association between the length and type of incision as well as the distance to the xiphoid process and respiratory muscle dysfunction. 4. Investigate the association between postoperative hypoxemia, myocardial ischemia and ischemic electrocardiographic (ECG) changes within three days of major emergency abdominal surgery 5. Describe the incidence of postoperative cardiac arrhythmias within three days of major emergency abdominal surgery and the association with postoperative cardiovascular complications within 30 days, 90 days and 1 year of surgery. 6. Describe the association between HRV and postoperative cardiovascular and non-cardiovascular complications within 30 days, 90 days and 1 year of surgery
Study Type
OBSERVATIONAL
Enrollment
350
Major emergency gastrointestinal surgery performed within 72 hours of an acute admission or an acute reoperation.
Department of Surgery, Zealand University Hospital, Denmark.
Køge, Denmark
RECRUITINGChange in postoperative maximal inspiratory mouth pressure from POD1 to POD3
Maximal inspiratory mouth pressure \[cmH2O\] is measured on the first and third postoperative day to asses the change
Time frame: 3 days
Change in postoperative maximal expiratory mouth pressure from POD1 to POD3
Maximal expiratory mouth pressure \[cmH2O\] is measured on the first and third postoperative day to asses the change
Time frame: 3 days
Length of surgical incision
The length of the surgical incision \[cm\] will be measured on the first postoperative day
Time frame: Day 1
Heart Rate Variability (HRV)
HRV assessed preoperatively - POD3, if this is not achievable then from POD0 - POD3
Time frame: 3 days
The occurence of per- and postoperative cardiac arrhythmias (until POD3)
The occurence of postoperative cardiac arrhythmia the first three days following surgery, with cardiac arrhythmia defined as: * Atrial fibrillation (AF) or * Atrial Flutter (AFL) or * Ventricular Tachycardia (VT- both monomorphic and polymorphic types) or * Recurrent sustained ventricular tachycardia (RSVT) or * Ventricular fibrillation (VF) or * Torsade de Pointes (TDP) or * 2nd degree atrioventricular (AV) block or * 3rd degree atrioventricular (AV) block
Time frame: 3 days
The occurence of per- and postoperative ischemic ECG changes (until POD3)
The occurence of per- and postoperative ischemic ECG changes the first three days following surgery, defined as: * ST-depression ≥ 0,5 mm at the J-point in ≥ 2 contiguous leads or * Inverted T waves ≥ 1 mm in ≥2 contiguous leads that have dominant R waves or * ST-elevation ≥ 1 mm in ≥ 2 contiguous leads, however * ST-elevation in V2-V3 ≥ 2,5 mm for males \< 40 years of age in ≥ 2 contiguous leads * ST-elevation in V2-V3 ≥ 2,0 mm for males ≥ 40 years of age in ≥ 2 contiguous leads * ST-elevation in V2-V3 ≥ 1,5 mm for females in ≥ 2 contiguous leads) or * In V2-V3: Any q wave ≥ 0,02 seconds, * In other leads: Q wave ≥ 0,03 seconds and \> 1 mm deep in ≥ 2 contiguous leads.
Time frame: 3 days
The occurence of postoperative hypoxemia during the first three postoperative days
The occurence of postoperative hypoxemia during the first three postoperative days, defined as: * the number of declines in saturation of 4 % (or more) lasting 20 seconds (or more) or * number of desaturation episodes below 90 % or * time (minutes( spent below 90 %,
Time frame: 3 days
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