[Respiratory morbidity in patients with and without pulmonary obstructive syndrome after upper abdominal surgery]

Abstract

Background: We wanted to determine the postoperative pulmonary complication after upper abdominal surgery in patients with pulmonary obstrutive syndrome.

Methods: We have studied 196 patients prospectively analyzed in preoperative period with spirometry and followed for observation of PPC. The patients were divided in four groups: COPD - those with chronic bronchitis or emphysema and VEF1/CVF< 70% (27 patients). ASMA - patients with obstruction of the airway in response to provoking stimuli (44 patients). CHRONIC BRONCHITIS-EMPHYSEMA - those with the clinical diagnoses of the respective diseases but VEF1/CVF > 70% (23 patients). NORMAL - patients without pulmonary disease and normal spirometry (102 patients).

Results: Postoperative pulmonary complication was recognized when the patient presented atelectasis with clinical or gasometric alterations; bronchospasm that needed bronchodilator therapy; respiratory failure; mechanical ventilation or orotracheal intubation more than 48 hours in postsurgery period; tracheobronchitis characterized by the presence of purulent sputum with normal x-ray; pneumonia. Patients with pulmonary obstruction had experienced higher rates of pulmonary complications (32% vs 6%, p<0.05). The presence of obstructive lung disease was associated with an increased number of ventilator days, but was not associated with longer intensive care unit or hospital stay.

Conclusions: The incidence of postoperative pulmonary complications was strongly associated with the presence of pulmonary obstructive syndrome.