BACKGROUND: We wanted to determine the postoperative pulmonary complicatiosn 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 entubation more than 48 hours in postosurgery period; tracheobronchitis characterized by the presence of purulent sputum with normal x-ray; pneumonia. Patients with pulmonary obstruction had experienced higher rates of pulmonar complications (32% vs 6%,p<0,05). The presence of obstuctive lung disease was associated with an increased number of ventilator days, but was not associeted with longer intensive care unit or hospital stay. CONCLUSIONS: The incidence of postoperative pulmonary complications was strongly associated with the presence of pulmonary obstrutive syndrome.
Abdominal surgery; Postoperative complications; Airway Obstruction
