Postoperative Pneumonia: What To Look For And How To Prevent It

Pneumonia can affect anyone at any time, but postoperative pneumonia is a complication that can occur in patients who undergo surgery. Postoperative pneumonia can be serious, so it’s important to know the signs and what to do to prevent it. 

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What is postoperative pneumonia? 

Postoperative pneumonia is an illness that can develop after surgery. Also referred to as hospital-acquired pneumonia or ventilator-associated pneumonia, postoperative pneumonia is the third most common surgical complication and is associated with an increased risk of death. 

Despite advances in surgical techniques, postoperative pneumonia still persists frequently as a post-surgery complication. 

Is pneumonia common after surgery?

Research tells us that postoperative pneumonia occurs in around 0.5–28% of patients who undergo surgery.¹

What does postoperative pneumonia look like?

The symptoms of postoperative pneumonia typically include cold-like symptoms such as:

  • A cough 

  • Chest pain 

  • Difficulty breathing 

  • Fever

  • Chills 

  • Nausea

  • Vomiting

  • Increased heart rate

  • Reduced blood pressure

  • Impaired cognition 

The problem with postoperative pneumonia is that many patients are unconscious or possibly intubated after surgery. This makes it hard to identify these symptoms as they occur. While the symptoms may not sound very serious, they can seriously impact post-surgery recovery. 

Research has shown that postoperative pneumonia can reduce a patient’s five-year survival rate by 66% following surgery. There is even evidence that postoperative pneumonia can negatively affect their recovery and quality of life. Postoperative pneumonia typically requires antibiotic treatment and further time in the hospital.²

What happens if you get pneumonia after surgery?

After infection, postoperative pneumonia may require antibiotic treatment and tends to extend hospital stay time. 

What causes postoperative pneumonia?

There is a range of reasons why a patient might develop postoperative pneumonia. The first is that following surgery and illness, patients tend to be immunocompromised. This makes them more vulnerable to infection that can lead to pneumonia. 

Postoperative pneumonia is usually caused by a bacterial infection. Typical cases involve gram-negative aerobic bacteria, such as:

  • Pseudomonas species

  • Klebsiella species

  • Enterobacter species 

Staphylococcus aureus is the most common gram-positive bacterial cause of postoperative pneumonia. 

Risk factors that increase the odds of developing postoperative pneumonia 

A few risk factors can increase a patient’s chances of developing postoperative pneumonia. These include:

  • Age: Older patients have an increased risk of developing postoperative pneumonia, particularly those over 60. 

  • Chronic obstructive pulmonary disease (COPD): COPD is a lung disease that obstructs airflow from the lungs, making patients more vulnerable to a lung infection like pneumonia. 

  • Emergency surgery: Due to the urgent nature of emergency surgery, patients can be exposed to poorer preoperative conditions, leaving them more likely to develop an infection. 

  • Postoperative reduced albumin: Albumin is a protein in blood plasma made by the liver. It is key to keeping fluid from building up in the lungs and other parts of the body. Postoperative levels of albumin under 35 g/L are a risk factor for postoperative pneumonia. 

  • Prolonged ventilation: If a patient is on a ventilator for over 24 hours, they are at an increased risk of developing postoperative pneumonia. 

  • Long bed rest: Bed rest that exceeds three days can increase a patient’s risk of developing postoperative pneumonia. 

Does anesthesia cause pneumonia? 

Anesthesia can contribute to postoperative pneumonia by causing gastric contents like stomach acid to enter the lungs, resulting in pulmonary complications and increased risk of infection. 

How to prevent postoperative pneumonia 

Preventing postoperative pneumonia involves work from both medical professionals and patients. Here are some things that patients can do to reduce their chances of developing postoperative pneumonia:

  • Don’t smoke.

  • Don’t excessively consume alcohol. 

  • Rest after surgery to prevent the lungs from ventilating fully, which can cause a build-up of fluid secretions that can encourage infection.

  • Follow medical advice. 

The lowdown 

Postoperative pneumonia exhibits symptoms similar to regular pneumonia, although the symptoms can be hard to detect if a patient is still unconscious after surgery. A range of risk factors can increase a patient’s chances of developing pneumonia after surgery, but with preventative care, this risk can be somewhat reduced.

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