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Abstract
There were 35 (or 4.6 per cent) pulmonary complications following 761 operations for
hernias and for pathologic conditions resulting from disease of the appendix in a
station hospital during the past two years. There was no mortality following these
operations.
Pulmonary complications were present in 10.4 per cent of 49 operations for severe
appendicitis and 2.6 per cent of 312 operations for uncomplicated appendicitis.
There were 22 (or 5.5 per cent) pulmonary complications after 400 operations for hernia.
Atelectasis was present alone or in combination in 17 cases and bronchitis or bronchopneumonia
was present in 17 cases. There was one small pulmonary infarct.
We do not believe that the use of spinal anesthesia is a factor in the development
of postoperative pulmonary complications.
The presence of infection of the upper respiratory tract, sinuses, teeth, tonsils,
or the lungs will increase the development of pulmonary complications.
Prevention of atelectasis is best accomplished by the preservation and activation
of the normal cough by reassurance, adequate explanation of the objective to the patient,
and the employment of turning, deep breathing, slapping on the back, and CO2 inhalations as adjuvants of psychotherapy all combining to result in normal expectoration
by the patient of the bronchial secretions.
Sulfadiazine and sodium bicarbonate are used routinely with pulmonary complications
because of the frequent impossibility of differentiating infection from atelectasis
early in the process and because atlectasis is frequently associated with infection.
Catheter aspiration or bronchoscopy is advocated if conservative measures fail.
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References
- Sulfathiazole and Sodium Sulfathiazole in the treatment of Postoperative Pneumonia.Surg. Gynec. & Obst. 1941; 72: 989
- Postoperative Pulmonary Complications: II. CO2 as a Preventive in a Controlled Series.J. A. M. A. 1933; 100: 21
- Postoperative Pulmonary Complications.Surg., Gynec. & Obst. 1933; 56: 43
- Observations on the Prevention and Treatment of Postoperative Atelectasis and Bronchopneumonia.Ann. Surg. 1941; 114: 243
- Some Aspects of Postoperative Pulmonary Complications.in: Ed. 2. Proc. Royal Soc. Med. 31. 1938: 1272
- Surgical Treatment of Bronchiectasis.Surgery. 1944; 15: 789-800
Article info
Publication history
Received:
November 21,
1944
Identification
Copyright
© 1945 Published by Elsevier Inc.
