Exploratory research on the inhibiting factors of postoperative pulmonary complications in patients with low pulmonary function
Nanami Kawazuraa Kazumasa Ogawab,c Haruko Tamuraa Yukako Koikea
aDepartment of Clinical Physiology, Toranomon Hospital
bDepartment of Respiratory Medicine, Respiratory Center, Toranomon Hospital
cCenter for Preventive Medicine, Nomura Hospital
Postoperative pulmonary complications (PPCs) are the primary causes of increased mortality rate and prolonged hospitalization after surgery. Low pulmonary function (LPF) has been reported as one of the important predictive factors for PPCs. In this retrospective study, we reviewed 74 preoperative patients with LPF using data from 13,643 patients who underwent a preoperative pulmonary function test at Toranomon Hospital between April 2013 and March 2017; the forced expiratory volume in the first second (FEV1) of these 74 patients was ≤1.0L. We found that none of the patients in this cohort reported PPCs. However, the surgical plan was changed in 6 patients and surgery was canceled in 14. The number of patients whose %FEV1 was \<50% was significantly higher in these 20 patients than in the remaining 54 patients (17 patients vs. 12 patients, p = 0.026). In addition, 15 patients had undergone respiratory function training prior to surgery and their forced vital capacity [+0.29 (−0.03 to 0.68) L, p = 0.011] and FEV1 [+0.27L (−0.05 to 0.57) L, p = 0.011] increased significantly. The occurrence of PPCs could be avoided in patients with LPF by changing their surgical plan or prescribing respiratory function training when appropriate.
Forced expiratory volume (FEV) Respiratory function test Postoperative complication Respiratory function training General anesthesia
Received 22 Jul 2020 / Accepted 14 Sep 2020
AJRS, 10(1): 10-16, 2021