Respiratory complications in postoperative patients

This study was conducted to see the extent of respiratory morbidity in the general surgical unit of a teritiary care teaching hospital and to look for probable factors that were responsible for them.

A prospective study was conducted over a six month period, of patients who underwent both elective and emergency surgeries. Patients were assessed pre-operatively, on the fifth post operative day and at the time of discharge for respiratory complications.

Five hundred eighty four consecutive patients who underwent surgeries were studied. Eighty one of them (13.9%) had respiratory complications. Pneumonia was the most common complication (68%). The others included pleural effusion, empyema, pneumothorax and exacerbations of asthma and chronic obstructive pulmonary disease (COPD). One patient developed ARDS (Adult respiratory distress syndrome) and died. Patients who underwent upper abdominal surgery (both elective and emergency), those who had a stay in the surgical ICU for more than 24 hours and those who were on the ventilator for more than 24 hours had a higher incidence of respiratory complications (p < 0.001).

Respiratory complications increase the morbidity in post operative patients. Pre-operative respiratory illnesses, upper abdominal surgery, ICU stay and mechanical ventilation in the post-operative period predispose patients to respiratory complications. Pre-operative respiratory assessment and treatment of any underlying respiratory disorder is necessary and may decrease the morbidity in surgical patients.