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Duggan, Michelle and Kavanagh, Brian P (2010) Perioperative modifications of respiratory function. Best Practice & Research: Clinical Anaesthesiology , 24 , (2) , pp. 145-155.

Postoperative pulmonary complications contribute considerably to morbidity and mortality, especially after major thoracic or abdominal surgery. Clinically relevant pulmonary complications include the exacerbation of underlying chronic lung disease, bronchospasm, atelectasis, pneumonia and respiratory failure with prolonged mechanical ventilation. Risk factors for postoperative pulmonary complications include patient-related risk factors (e.g., chronic obstructive pulmonary disease (COPD), tobacco smoking and increasing age) as well as procedure-related risk factors (e.g., site of surgery, duration of surgery and general vs. regional anaesthesia).

Careful history taking and a thorough physical examination may be the most sensitive ways to identify at-risk patients. Pulmonary function tests are not suitable as a general screen to assess risk of postoperative pulmonary complications. Strategies to reduce the risk of postoperative pulmonary complications include smoking cessation, inspiratory muscle training, optimising nutritional status and intra-operative strategies. Postoperative care should include lung expansion manoeuvres and adequate pain control.

Item Type:Article
Page Range:pp. 145-155
Accession Number:HRB (Not in collection)
Subjects:VA Geographic area > Europe > Ireland
G Health and disease > State of health > Physical health
J Health care, prevention and rehabilitation > Risk and needs assessment > Risk assessment
J Health care, prevention and rehabilitation > Patient care management
B Substances > Tobacco (cigarette smoking)

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