Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

Abstract

OBJECTIVE:Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior).METHODS:We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique.RESULTS:The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L) and FVC (2.0±0.7 L) with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p = 0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed.CONCLUSIONS:Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery.

Effect of Preoperative Breathing Exercise on Postoperative Patients’ Lung Functions

“…This may be due to both groups were had resemble characteristic and functionally comparable to each other. The present result is similar to a study conducted by (13,14) are similar with the result of present study, and the pulmonary function test parameters did not differ between two groups before operation. After the application of the breathing exercise pursed lip methods through the present study, the results indicated that there is an improvement in the case group lungs volumes compared with those patients in the control group.…”

Opioid use may be associated with postoperative complications in myotonic dystrophy type 1 with high-grade muscular impairment

“…There is substantial evidence to prove that DM1 patients show abnormalities with regard to the ventilator control mechanisms, and their conditions became more critical when exposed to anaesthetic agents, resulting in a low central respiratory drive 14 , 15 . Furthermore, this hypothesis can be consolidated by our result in which 9 of 11 patients received abdominal surgery, which is an important risk factor of hypoventilation 16 .…”

“…There is substantial evidence to prove that DM1 patients show abnormalities with regard to the ventilator control mechanisms, and their conditions became more critical when exposed to anaesthetic agents, resulting in a low central respiratory drive 14,15 . Furthermore, this hypothesis can be consolidated by our result in which 9 of 11 patients received abdominal surgery, which is an important risk factor of hypoventilation 16 . www.nature.com/scientificreports/ www.nature.com/scientificreports/ The concerns regarding increase in the risk of defects in the cardiac rhythm conduction and potential progression of known conduction delays in patients with DM1 during the perioperative period are evident 17 .…”

Physiotherapeutic approach in women undergoing hysterectomy

“…Breathing exercises were part of the protocol of two studies (26,27) of this review, and another study (22) focused on guidelines for performing correct breathing during exercises to strengthen the AP. According to De Cleva et al (39) , lower abdominal surgery is associated with a 10 to 15% decrease in functional residual capacity. Recent study (40) demonstrated that respiratory physiotherapy plays an important role in improving vital capacity (VC) in patients undergoing abdominal surgery, being performed breathing exercises associated with upper limb exercises and assisted coughing, in addition to lower limb exercises, ending with the use of intermittent positive pressure or incentive spirometer, depending on the group, and both groups obtained positive results.…”