[Respiratory morbidity in patients with and without pulmonary obstructive syndrome after upper abdominal surgery].
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.
Pereira
E D
ED
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP.
Farensin
S M
SM
Fernandes
A L
AL
D000368:Aged; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology; D011446:Prospective Studies; D013147:Spirometry; D013577:Syndrome; D019616:Thoracic Surgical Procedures / Q000379:methods*