Ventilatory patterns and pulmonary complications after upper abdominal surgery determined by preoperative and postoperative computerized spirometry and blood gas analysis

Latimer, Ronald G.; Dickman, Marion L.; Day, W.Clinton; Gunn, Margaret L.; Schmidt, Candice

doi:10.1016/0002-9610(71)90290-x

Cited by 252 publications

(28 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Latimer, et al, 8 have reported that when preoperative %FVC and %FEV 1 values fell below 70 and 65%, respectively, the risk of postoperative respiratory dysfunction was increased. The %FVC dropped below 70% in 10.5% of the patients in the CCM group, whereas this occurred in only 1.2% in the control group, also indicating greater risk in the former group.…”

Section: Discussionmentioning

confidence: 98%

Does chronic cervical myelopathy affect respiratory function?

Toyoda¹,

Nakamura²,

Konishi³

et al. 2004

Journal of Neurosurgery: Spine

View full text Add to dashboard Cite

Object. Although respiratory function is often impaired by acute cervical spinal cord injury, changes in respiratory function in patients with chronic cervical myelopathy (CCM) are not well documented. The purpose of this study was to evaluate the respiratory function of patients with CCM. Methods. Spirometric parameters were measured in 94 patients with CCM before they underwent expansive laminoplasty. These measurements were compared with those obtained in age- and sex-matched control group patients without myelopathy. The study patients were also subdivided into two groups: those with spinal compressive lesions above or below the C3–4 disc level were compared in terms of respiratory function. The vital capacity values measured in patients with CCM were significantly lower than those in the control group. In patients in whom spinal cord compression was present above C3–4, vital capacity values were lower than in patients in whom the compression level was below C3–4. The resting respiratory rate per minute was elevated in the CCM group. Peak expiratory flow rate was significantly decreased, and expiratory velocities at 50 and 25% of vital capacity were significantly increased in the CCM group. Conclusions. The results indicated that expiratory flow may be impaired or incomplete in patients with CCM. An underlying subclinical respiratory dysfunction appears to be associated with CCM.

show abstract

Section: Discussionmentioning

confidence: 98%

Does chronic cervical myelopathy affect respiratory function?

Toyoda¹,

Nakamura²,

Konishi³

et al. 2004

Journal of Neurosurgery: Spine

View full text Add to dashboard Cite

show abstract

“…In addition, a restrictive ventilatory defect has been described. These changes may lead to poor ventilation, hypoxemia, and atelectasis (4)(5)(6)(7). Respiratory muscle dysfunction has been shown to be one of the primary causes of these alterations (8,9), and phrenic nerve inhibition is currently the most attractive explanation for this diaphragmatic dysfunction (10)(11).…”

mentioning

confidence: 99%

Effects of laparoscopic cholecystectomy on global respiratory muscle strength.

Rovina

Bouros²,

Tzanakis³

et al. 1996

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Laparoscopic cholecystectomy has a better postoperative outcome than the traditional open technique, which has been shown to significantly affect respiratory muscle function. The aim of this study was to investigate the effects of laparoscopic surgery on respiratory function, and particularly that of the respiratory muscles. Respiratory muscle strength was assessed in 26 patients who underwent laparoscopic cholecystectomy and in 25 who underwent open cholecystectomy by measuring mouth pressure during maximum static inspiratory (PImax) and expiratory (PEmax) efforts. PImax, PEmax, and blood gases were measured 24 h preoperatively (-24 h) as well as 24 h (+24 h) and 48 h (+48 h) postoperatively. FEV1 and FVC were measured at -24 h and +48 hr, and the ratio of FEV1 to FVC (FEV1/FVC) was calculated. PImax decreased at +24 h and +48 h in both groups, but this decrease was significantly greater in the patients who had open surgery, (p < 0.01, and p < 0.005, respectively). Similarly, PEmax was significantly smaller in the open- than in the laparoscopic-surgery group (p < 0.0001) at +48 h. Spirometric indices showed a more severe restrictive defect at +48 h after open surgery than after laparoscopy (p = 0.01). The arterial oxygen tension (PaO2) was significantly greater in the laparoscopic- than in the open-surgery group at +24 h (p < 0.007). Laparoscopic cholecystectomy caused smaller decreases in respiratory muscle strength than did open surgery. This accords with the hypothesis of phrenic nerve inhibition during open surgery. The results are of clinical importance, since they may explain the different outcomes with the two techniques.

show abstract

“…Indeed, these findings are similar to data reported in the literature after major abdominal surgery. [16][17][18][19] Conflicting data were reported by Nevelsteen et al .20 They randomized 30 consecutive aortic reconstruction patients to retroperitoneal vs. transperitoneal operations and measured sequential pulmonary function tests before and after surgery. They reported a significant advantage in these tests for the retroperitoneal approach on postoperative day 2.…”

Section: Pulmonary Dysfunction With Aortic Surgerymentioning

confidence: 74%

Advantages of the Retroperitoneal Approach for Aortic Surgery: Fact or Fancy?

Cambria¹,

Brewster²

1990

Perspectives in Vascular Surgery and Endovascular Therapy

View full text Add to dashboard Cite

Much of what is perceived as new and better in surgery is, in fact, a reconsideration of earlier ideas framed in the context of modern clinical practice. Since it is the inevitable tendency of surgeons to offer their patients the best of current practice, such &dquo;advances&dquo; in surgical care are often applied prior to actual scientific demonstration of their true benefit. In the past decade several examples of perhaps inappropriate enthusiasm can be cited, including the alleged superiority of the in situ vein graft, nonresective treatment of aortic aneurysm in high-risk patients, and the contention that the retroperitoneal approach is the preferred route for aortic reconstruction.A critical appraisal of the literature claiming superiority for the retroperitoneal approach reveals two distinct flaws, namely, the limitations of retrospective review and the use of historical controls. It has been our observation that a number of factors, including (but not limited to) better cardiac risk stratification, newer anesthetic techniques, and autotransfusion, have contributed to the ever-improving safety of aortic surgery at the Massachusetts General Hospital. Thus it was clear that a prospective study with randomization would be required to isolate and examine the variable of surgical approach and in this way address the contention that the retroperitoneal approach is the more &dquo;physiologic&dquo; route for aortic reconstruction. In this article we review the evolution of experience with the retroperitoneal operation and offer a critique of those individual tenets of aortic reconstruction said to be favorably influenced by use of a retroperitoneal approach. This is done from the perspective of our own randomized study of this question in which we demonstrated no important advantage for the retroperitoneal approach. BACKGROUND

show abstract

Ventilatory patterns and pulmonary complications after upper abdominal surgery determined by preoperative and postoperative computerized spirometry and blood gas analysis

Cited by 252 publications

References 48 publications

Does chronic cervical myelopathy affect respiratory function?

Does chronic cervical myelopathy affect respiratory function?

Effects of laparoscopic cholecystectomy on global respiratory muscle strength.

Advantages of the Retroperitoneal Approach for Aortic Surgery: Fact or Fancy?

Contact Info

Product

Resources

About