Pulmonary dysfunction and surgical risk. How to assess and minimize the hazards

Postoperative deterioration of pulmonary function can be considerable, resulting in hypoxemia and atelectasis, if such effects are not anticipated and efforts made to prevent or minimize them. The risk of postoperative pulmonary complications depends on the patient's age, degree of obesity, and cigarette consumption; the type of surgery to be performed; and the anesthetic agent used. Assessment of risk is based primarily on clinical and laboratory evaluations. The tests performed may vary from patient to patient, and specialized studies of regional pulmonary function are frequently required. Even though a patient may be identified as having a high risk of postoperative pulmonary complications, risk can often be decreased through a number of preoperative and intraoperative measures as well as a postoperative therapeutic program.