Upper abdominal surgery: does a lung function test exist to predict early severe postoperative respiratory complications?

Background: Postoperative pulmonary complication is a major cause of morbidity, mortality, prolonged hospital stay and increased cost of care especially when it involves Upper Abdominal surgery. The predictable changes in lung function include a decrease in vital capacity and functional residual capacity, which are more striking in obese patients and in the supine. Aim is to study the incidence of respiratory complications in patients undergoing elective upper abdominal surgery with identification of risk factors namely Age, Sex, Obesity, Smoking and duration of upper abdominal Surgery for the development of Respiratory complications using a Peak Flow Meter as a bedside predictive test.Methods: Peak expiratory flow rate (PEFR) measurement daily up to 7 days post-surgery, were noted to monitor the occurrence of postoperative respiratory complications.Results: The study results according to our study showed that14 (34.1%) male patients out of 41 had postoperative complications as compared to 15 (48.3%) out of 31 female patients. 30.5% patients were obese and had postoperative complications of 9.75%. Overall 40% of smokers had postoperative complications. Postoperatively sub costal incision had complications (41%) in 36 patients, roof top incisions 4 out of 5 (80%) and para-umbilical incisions 3 out of 4 (75%). 80% of the patients who had upper abdominal transverse incisions developed microatelectasis followed by 75% of patients who had par median incisions.Conclusions: Respiratory complications following elective upper abdominal surgery are influenced by Increasing age and obesity and Smoking affected post-operative pulmonary recovery. Type of incision could also help change the incidence of complications.

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Faculty Opinions recommendation of Ventilation with low tidal volumes during upper abdominal surgery does not improve postoperative lung function.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717952385.793457907 ◽

2012 ◽

Author(s):

Timothy Short

Keyword(s):

Lung Function ◽

Abdominal Surgery ◽

Upper Abdominal Surgery ◽

Upper Abdominal ◽

Postoperative Lung Function

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Lung function after major upper abdominal surgery in patients with mild to moderate COPD: A randomized comparison between repeat boluses of epidural morphine/ropivacaine and a P.C.E.A for postoperative analgesia

European Journal of Anaesthesiology ◽

10.1097/00003643-200805001-00251 ◽

2008 ◽

Vol 25 (Sup 44) ◽

pp. 79 ◽

Cited By ~ 1

Author(s):

M. Perdiou ◽

V. Panaretou ◽

D. Markopoulou ◽

V. Tsekoura ◽

L. Georgiou

Keyword(s):

Lung Function ◽

Abdominal Surgery ◽

Postoperative Analgesia ◽

Epidural Morphine ◽

Upper Abdominal Surgery ◽

Upper Abdominal

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Eine einmalige Atemphysiotherapie vor geplanten Oberbauchoperationen vermindert postoperative respiratorische Komplikationen

Physikalische Medizin Rehabilitationsmedizin Kurortmedizin ◽

10.1055/a-0569-6799 ◽

2018 ◽

Vol 28 (02) ◽

pp. 71-71

Keyword(s):

Randomised Controlled Trial ◽

Abdominal Surgery ◽

Controlled Trial ◽

Respiratory Complications ◽

Upper Abdominal Surgery ◽

Upper Abdominal ◽

Randomised Controlled ◽

Double Blinded

Referat zur Arbeit von Boden I, Skinner EH, Browning L, Reeve J, Anderson L, Hill C, Robertson IK, Story D, Denehy L. Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial. BMJ 2018; 360: j5916In einer multizentrischen randomisierten, Placebo-kontrollierten Studie an 441 Patienten wurde nachgewiesen, dass eine einmalige Atemphysiotherapie vor geplanten Oberbauchoperationen die Zahl von postoperativen respiratorischen Komplikationen drastisch verringern kann. Die Untersuchung wurde an Universitätskrankenhäusern in Australien und Neuseeland im Doppelblind-Design durchgeführt.

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