Preoperative evaluation of the pulmonary patient undergoing nonpulmonary surgery

As the human population continues to live longer, patients with chronic pulmonary disease are increasingly presenting for surgical treatment. The influences of general anesthesia and an operative procedure are well known to negatively impact pulmonary gas exchange. Pulmonary-compromised patients are at high risk for the development of perioperative complications as a consequence of not only their pulmonary disease but of associated comorbid disease processes. Certain risk factors associated with preexisting pulmonary conditions are known to increase the likelihood of intraoperative or postoperative complications. Essential components in the comprehensive care of these patients are the identification of these high-risk patients and the implementation of an inclusive perianesthetic care regimen designed to decrease pulmonary complications. This article will familiarize the perianesthetic nurse with pertinent skills required to effectively assess and prepare patients with pulmonary disease for their upcoming surgery.