PREOPERATIVE PULMONARY-FUNCTION AND COMPLICATIONS AFTER CARDIOVASCULAR-SURGERY

Results of preoperative pulmonary function tests were evaluated in 106 patients who had major thoracic or upper abdominal cardiovascular surgery. These results were related to the occurrence of postoperative complications by comparison of pulmonary function data in patients with an ICU stay of <5 days versus patients with an ICU stay of >5 days. However, quantitative analysis of several specific parameters of pulmonary function tests failed to reveal any differences in the incidence of postoperative complications between patients with modest versus severe preoperative dysfunction. The occurrence of atelectasis was related to type of cardiovascular surgical procedure, but not to preoperative pulmonary function tests. Abnormalities on pulmonary function tests were not the major determinants of use of preoperative respiratory therapy, and its use was unrelated to the length of stay postoperatively in the ICU. It is concluded that prior to cardiovascular surgery, routine quantitation of clinically apparent pulmonary dysfunction may be of little value in predicting postoperative morbidity and much less important than careful clinical evaluation. When pulmonary function tests are performed in such patients, simple spirometric tests and arterial blood gas levels are adequate.