[A retrospective study on postoperative pulmonary dysfunction as a function of the surgical injury]

Pre- and postoperative pulmonary function tests were studied retrospectively in 80 patients. They were divided into one of 5 groups: 1, surgery of the upper abdomen; 2, surgery of the lower abdomen; 3, surgery of the body surface; 4, thoracic surgery; and 5, extensive abdominal surgery. Postoperative pulmonary function tests were performed when the patients recovered to be able to sit up. The time necessary to reach this stage varied from 8 th postoperative day in groups 1, 2, and 3 to 24 postoperative day in groups 4 and 5. FRC, %FEV1.0, V25, and TV were unchanged in groups 1 and 2 postoperatively. There was a significant reduction in VC to 81.6 +/- 24.1% and 89.1 +/- 13.3% of the preoperative value in group 1 and 2, respectively. A significant decrease in TLC and a significant increase in RV were observed in group 1. The changes in pulmonary mechanics can be attributed to the muscle dysfunction during inspiratory and expiratory effort. A decrease in TLC and an increase in RV were also observed in group 2. All of the pulmonary function variables remained unchanged postoperatively in group 3. The restrictive pulmonary dysfunction with significantly reduced VC was observed in groups 4 and 5. V50 and V25 were significantly decreased in group 4. These changes could be attributed to the use of the extracorporeal circulation during cardiac surgery and the postoperative mechanical ventilation. TLC decreased significantly in groups 4 and 5, and RV increased significantly in group 5, but unchanged in group 4. The results indicate that the expiratory muscles function normally following the thoracic surgery.(ABSTRACT TRUNCATED AT 250 WORDS)