Pulmonary Complications, Ventilation and Blood Gases after Upper Abdominal Surgery

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<jats:p>Forty patients who underwent elective cholecystectomy were examined preoperatively and during the first postoperative week by physical examination, measurement of FVC and FEV<jats:sub>1</jats:sub>, arterial pH and blood gas analyses, and chest x‐ray. Postoperative pulmonary complications (p.p.c.) were detected in 30 (75%) of the patients. Simple auscultation was the most sensitive tool in discovering p.p.c., but 18 of the 30 patients with complications also had a pathological chest x‐ray.</jats:p><jats:p>Obesity, smoking, postoperative naso‐gastric tube and postoperative wound infection were predisposing factors for p.p.c. Six patients with preoperative pulmonary disease all had a progress in their lung pathology. There was no definite relationship of duration of anaesthesia or drainage of the abdominal wound to development of p.p.c.</jats:p><jats:p>The patients with p.p.c. showed a deeper and more prolonged fall in Pa<jats:sub>o2</jats:sub> postoperatively than the normal group. None of the normals showed an arterial P<jats:sub>o2</jats:sub> below 70 mmHg in the postoperative course, while 63% of the p.p.c. group did.</jats:p><jats:p>FVC and FEV<jats:sub>1</jats:sub> showed marked reductions from preoperative values on the first postoperative day, and then gradually increased to near preoperative values after 1 week. Arterial pH and P<jats:sub>co2</jats:sub>, showed no definite changes during the postoperative course.</jats:p>

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