Pulmonary Risk Management in the Perioperative Setting


Summary

As a consultant, hospitalists commonly risk stratify and offer risk reduction strategies for patients undergoing surgery. Effective perioperative pulmonary risk consultation requires hospitalists to identify patient- and procedure-related predictors for developing postoperative pulmonary complications and to propose strategies to reduce the risk. The following module will examine these topics and provide evidence-based risk reduction strategies. In addition, the role of routine preoperative spirometry and chest radiograph will be discussed.

Goal
To provide hospitalists with a guide to perioperative pulmonary risk stratification and discuss modalities to reduce the risk of perioperative pulmonary complications.
Target Audience
This activity is designed for hospitalists. No prerequisites required.
Learning Objectives

After completing the module, the participant should be able to:

  1. Recognize the impact of postoperative pulmonary complications.
  2. Identify risk factors associated with higher incidence of postoperative pulmonary complications.
  3. Examine the role of routine preoperative spirometry and chest radiograph.
  4. Evaluate the evidence-based risk reduction strategies.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

CME Information
Accreditation Statement: The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement: The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 2 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: November 15, 2008. Expiration date: November 15, 2010.

Estimated time to complete activity: 2 hours
Faculty & Faculty Disclosures
Full Disclosure Policy Affecting CME Activities: As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of The Johns Hopkins University School of Medicine to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The presenting faculty reported the following:

*Fellow in Pulmonary Care and Critical Care Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Tufts University, Boston, Massachusetts.

Associate Professor of Medicine, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Conflict of Interest: Dr Kher and Dr Smetana report having no significant financial or advisory relationships with corporate organizations related to this activity.

Off-Label Product Discussion: All faculty have indicated that they have not referenced unlabeled or unapproved uses of drugs or devices.

Disclaimer: The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Address correspondence to: Sucharita Kher, MD, Tufts Medical Center, 800 Washington Street, Holmes 2, Boston, MA 02111. E-mail: skher@tuftsmedicalcenter.org.
References
Click here to download the references for this educational activity.
Instructions
The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, a study activity, and a CME post-test. All 3 sections must be completed to receive CME credit.


Supported by an educational grant from Merck & Co., Inc.