The prevention of pulmonary complications after upper abdominal surgery in patients with noncompromised pulmonary status
J. A. Roukema, E. J. Carol and J. G. Prins
Department of Surgery, Catherina Hospital, Eindhoven, The Netherlands.
Controversy exists regarding the routine use of breathing exercises in the
prevention of pulmonary complications after upper abdominal surgery. We
prospectively randomized 153 patients who had noncompromised pulmonary
status; the control group (84 patients) engaged in no breathing exercises,
and the respiratory therapy group (69 patients) engaged in preoperative and
postoperative breathing exercises supervised by the physical therapist.
Postoperative pulmonary complications were classified using criteria
derived from chest roentgenograms, arterial blood gas samples, and
temperature registration. The incidences of postoperative complications in
the treatment group and in the control groups were 19% and 60%,
respectively. In the present study, preoperative lung function tests had no
additional or predictive value. We advise preoperative and postoperative
breathing exercises as a prophylactic treatment in all patients scheduled
for upper abdominal surgery.
