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Postoperative Complications Overview

The document outlines various postoperative complications, including hepatic dysfunction, renal failure, urinary tract infections, and postoperative confusion. It details the causes of these complications, such as increased bilirubin load, prerenal hypoperfusion, and the risk factors for urinary infections related to catheter use. Additionally, it highlights the clinical features and potential causes of postoperative confusion, emphasizing the importance of monitoring and prevention strategies.

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Kandy Emmy
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38 views2 pages

Postoperative Complications Overview

The document outlines various postoperative complications, including hepatic dysfunction, renal failure, urinary tract infections, and postoperative confusion. It details the causes of these complications, such as increased bilirubin load, prerenal hypoperfusion, and the risk factors for urinary infections related to catheter use. Additionally, it highlights the clinical features and potential causes of postoperative confusion, emphasizing the importance of monitoring and prevention strategies.

Uploaded by

Kandy Emmy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Other postoperative complications

Causes of postoperative hepatic dysfunction

• Increased bilirubin load


o Blood transfusion
o Haemolysis
o Haemolytic disorders
o Abnormalities of bilirubin metabolism
• Hepatocellular damage
o Pre-existing hepatic disease
o Viral hepatitis
o Sepsis
o Hypotension
o Hypoxaemia
o Drug-induce hepatitis
o Congestive cardiac failure
o General anaesthetic induced hepatic necrosis
• Extra-hepatic biliary obstruction
o Gallstones
o Ascending cholangitis
o Pancreatitis
o Common bile duct injury

Causes of postoperative renal failure

• Prerenal (hypoperfusion)
o Shock (hypovolaemia, cardiogenic, septic)
o Renal artery disease
• Renal (direct injury)
o Acute tubular necrosis (following prerenal, drugs, myoglobin)
o Glomerulonephritis
o Interstitial nephritis
• Postrenal (obstruction)
o Bladder outflow obstruction
o Single ureter (calculus, tumour)
o Both ureters (bladder malignancy)

Urinary tract infections

• 10% of patients admitted to hospital have a urinary catheter inserted


• Risk of catheter-related infection depends on:
o Age and sex of patient
o Duration of catheterisation
o Indication for catheterisation
• Bacterial colonisation of catheters is common
• If catheter required for more than 2 weeks 90% patients will develop bacteriuria
• Commonest organisms are enterobacter and enterococci
• Does not require treatment unless patient is systemically unwell
• Infection can be prevented by:
o Maintaining closed drainage system
o High infection control standards
o Preventing backflow from catheter bag

Postoperative confusion

• Occurs in 10% of postoperative patients


• Associated with increased morbidity and morality
• Leads to increased duration of hospitalisation
• Clinical features include
o Reduced level of consciousness
o Impaired thinking
o Impaired memory
o Perceptional abnormalities
o Disturbed emotion
o Psychomotor disturbance

Causes

• Hypoxia - respiratory disease, cardiac failure, arrhythmia


• Trauma - head injury
• Infection - intracranial, extracranial
• Neoplasia - primary and secondary cerebral tumours
• Vitamin deficiency - Thiamine (Wernicke’s encephalopathy), B12 deficiency
• Endocrine - hypothyroidism, hyperthyroidism, Addison’s disease
• Degenerative
• Vascular - CVA, TIAs
• Drugs
• Metabolic derangement

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