Respiratory complications following surgery. Improved prediction with preoperative spirometry

Patients who are old, overweight, who smoke and/or have symptoms of respiratory disease have an increased risk of atelectases and/or arterial hypoxemia in conjunction with surgery. The present study in 53 middle-aged men, operated on for gallbladder or peptic ulcer disease, illustrates how spirometry can be used to improve the prediction of respiratory complications. The relative risk of atelectases was greater in patients with functional residual capacity-closing capacity (FRC-CC) below -0.11 and the risk prediction based on age, body weight, smoking habits and respiratory symptoms was improved by adding information on FRC-CC. Arterial hypoxemia was more common in patients with wash-out volumes (WOV) above than below 35 l. The preoperative identification in high-risk patients of arterial hypoxemia based on the above-mentioned risk factors, was improved by adding information on WOV.