Preoperative Assessment of Pulmonary Risk

      Study objectives

      A summary of current modalities for and the utility of preoperative assessment of pulmonary risk.

      Design

      Review of recent literature published in the English language.

      Setting

      Not applicable.

      Patients or participants

      Patients who undergo elective cardiothoracic or abdominal operations.

      Interventions

      Not applicable.

      Measurements and results

      Postoperative pulmonary complications occur after 25 to 50% of major surgical procedures. The accuracy of the preoperative assessment of the risk of such complications is only fair. The routine assessment for all preoperative patients includes age, general physiologic status, and the nature of the planned operation. Specific tests such as measurement of spirometric values and diffusing capacity are indicated routinely only for patients who are candidates for major lung resection or esophagectomy.

      Conclusions

      Pulmonary complications are an important form of postoperative morbidity after major cardiothoracic and abdominal operations. The appropriate preoperative assessment of the risk of such complications is well defined for lung resection and esophagectomy operations, but it requires refinement for general surgical and cardiovascular operations.
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