Background and Goal of Study: Un-planned critical care admission is a devastating complication of lung resection. Within the UK Association of Cardiothoracic Anaesthesia and Critical Care's annual collaborative audit into Critical care Admission following Lung Resection (CALoR) we sought to characterise this patient
population, providing an up to date estimate of incidence, and explore patient outcome. Materials and Methods: This was a multicentre retrospective audit examining adult patients undergoing lung resection in 2013-2014. Critical care admission was defined as un-planned need for intubation with mechanical ventilation and/or renal replacement therapy. Sixteen UK centres contributed to the audit where detailed demographic and clinical data were collected on every patient admitted to critical care. Centres also provided the total number of patients undergoing lung resection within the study period. Results and Discussion: A total of 11,208 patients underwent lung resection with 253 requiring critical care – an admission rate of 2.26%. Respiratory failure was the primary cause of admission in 68% of cases, with infection and sputum retention being the most common diagnoses; 88% of all patients received antibiotics targeted at a respiratory source of infection. Overall critical care mortality was 36%. Eighty percent of survivors were discharged home whilst the remainder were transferred to other care facilities.The mean duration of mechanical ventilation, intensive care and hospital stay was 14, 19 and 33 daysrespectively. Tracheostomy was used to facilitate liberation from mechanical ventilation in 49% of patients Conclusion(s): This is the largest study examining unplanned critical care admission following lung resection reported to date. There exists significant therapeutic nihilism concerning the deteriorating postoperative lung resection patient, anticipating poor outcomes. Though patients admitted to critical care following lung resection undoubtedly have significant resource requirement, we suggest a survival rate of 64% is encouraging. Future work should allow analysis of the longer-term impact of critical care admission on functional capacity and quality of life. Large scale, prospective audit and research tailored towards this challenging patient cohort would allow for better understanding of factors associated with critical careadmission and outcome, and could potentially allow development of a risk prediction model.

05 / Critical Care After Lung Resection - Incidence and Outcome