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Pulmonary function in the early postoperative period

P S Parfrey, P J Harte, J P Quinlan

    The British Journal of Surgery
    |June 1, 1977
    PubMed
    Summary
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    Postoperative hypoxemia and spirometry changes after surgery were analyzed. Upper abdominal surgery patients experienced more atelectasis, with falling PO2 being the earliest indicator.

    Area of Science:

    • Anesthesiology
    • Pulmonary Medicine
    • Surgical Research

    Background:

    • Pulmonary function changes in the early postoperative period are not well-documented.
    • General anesthesia consistently leads to hypoxemia.
    • The impact of surgical site on respiratory function requires further investigation.

    Purpose of the Study:

    • To analyze the effect of regional surgery on respiratory function.
    • To monitor pulmonary function every 4 hours during the first 2 postoperative days.
    • To identify early indicators of postoperative atelectasis.

    Main Methods:

    • Continuous monitoring of pulmonary function, including spirometry and PO2 levels.
    • Analysis of respiratory changes in relation to surgical incision site.

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  • Observation of clinical signs and radiological findings of atelectasis.

    • Main Results:

    • Hypoxemia was universal in patients under general anesthesia.
    • The extent and duration of hypoxemia and spirometry alterations correlated with surgical site.
    • Upper abdominal surgery was associated with a higher incidence of atelectasis.
    • A decrease in PO2 was the earliest sign of atelectasis, preceding clinical and radiological findings.
    • Auscultatory findings were unreliable indicators of hypoxemia severity or presence of atelectasis.

    Conclusions:

    • Falling PO2 is the earliest indicator of postoperative atelectasis.
    • Clinical auscultation is not a sensitive method for detecting postoperative hypoxemia or assessing its severity.
    • Radiology is an imprecise tool for evaluating postoperative atelectasis.
    • Respiratory monitoring is crucial in the early postoperative period, especially after upper abdominal surgery.