A specialised nurse-led respiratory assessment in 157 cardiac surgery patients led to early admission for preoperative optimisation in 52%, a new respiratory diagnosis in 4%, and 4% being deemed unfit for surgery.
Observational (n=157)
No
Abstract Rationale Respiratory complications following cardiac surgery significantly contribute to morbidity and mortality, therefore it is vital to identify and manage pre-operative respiratory disease. A nurse-led respiratory assessment can be crucial in this pre-operative pathway. Methods This abstract expands on Madden et al. (2025) about the importance of nurse-led respiratory assessments before cardiac surgery. Routine pre-operative evaluation included complete history taking, chest x-ray and pulmonary function tests (spirometry and full lung function test with transfer factor). Abnormal results were jointly reviewed with a respiratory consultant three times weekly. Further investigations were requested, as indicated. These included arterial blood gas analysis, computed tomography (CT) thorax, right heart catheterisation (RHC) and patient face to face review with a respiratory consultant as required. Results 157 patients received respiratory assessment between October 2024 and October 2025. There were 119 outpatients (76%) and 38 inpatients (24%) with 218 virtual consultant patient reviews (range 1-3 consultations per patient). 19 patients (12%) required face-to-face review with a respiratory consultant to assess fitness for surgery. 82 patients (52%) required early admission for preoperative optimisation with nebulisation therapy. Additional specialised investigations were: CT thorax in 39 patients (25%), arterial blood gas in 28 patients (18%), and RHC to assess cardiopulmonary haemodynamics and pulmonary vascular resistance in 11 patients (7%). Six patients (4%) were given a new respiratory diagnosis. Seven patients (4%) were deemed unfit for surgery and were referred for alternative treatments. Conclusions A specialised nurse-led respiratory assessment is effective in diagnosing and managing pre-operative respiratory disease for cardiac surgery patients. This enables the development of bespoke management plans to optimise respiratory care and improve outcome. In addition to a positive impact on patient care, this service affords an important benefit to staff morale and provides a forum for education and research. References Madden, A., Bowles, C., Norton, H., Alarilla, V., Zafar, M., Madden, B. P., (2025) The Expanding Role of Nurse-led Pre-operative Clinics for Respiratory Assessment, Management, and Optimisation of Elective Cardiac Surgical Patients. American Journal of Respiratory and Critical Care Medicine. 211. A2982. This abstract is funded by: Cardiothoracic Surgery Department, St George’s University Hospitals NHS Foundation Trust
Alarilla et al. (Fri,) conducted a observational in Pre-operative respiratory disease in cardiac surgery patients (n=157). Specialised nurse-led respiratory assessment was evaluated on Pre-operative respiratory assessment outcomes (e.g., early admission for optimisation, new diagnosis, unfit for surgery). A specialised nurse-led respiratory assessment in 157 cardiac surgery patients led to early admission for preoperative optimisation in 52%, a new respiratory diagnosis in 4%, and 4% being deemed unfit for surgery.