What is the role of spirometry in predicting risk for surgical pulmonary complications?

Updated: May 14, 2020
  • Author: Kevin McCarthy, RPFT; Chief Editor: Nader Kamangar, MD, FACP, FCCP, FCCM  more...
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Answer

Answer

While no single test can effectively predict intraoperative and postoperative morbidity and mortality from pulmonary complications, the FEV1 obtained from good quality spirometry is a useful tool. When the FEV1 is greater than 2 L or 50% of predicted, major complications are rare.

Operative risk is heavily dependent on the surgical site, with chest surgery having the highest risk for postoperative complications, followed by upper and lower abdominal sites. Patient-related factors associated with increased operative risk for pulmonary complications include preexisting pulmonary disease, cardiovascular disease, pulmonary hypertension, dyspnea upon exertion, heavy smoking history, respiratory infection, cough (particularly productive cough), advanced age (>70 y), malnutrition, general debilitation, obesity, and prolonged surgery.


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