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Alan K. Pierce, MD. and Joy Robertson, MD. Pulmonary Disease Division, Department of Medicine, University of Texas Southwestern Medical School, Dallas, Texas -:-7238 Surgical patients who require general anesthesia may experience a variety of pulmo nary complications. The seriousness of these problems is reflected in a report that 13.1% of postoperative deaths are secondary to pulmonary pathology (I). Since hypoxemia, the most frequent physiologic alteration due to lung disease in the perioperative period, exerts its effect on other organs, the morbidity and mortality secondary to pulmonary complications may be grossly underestimated. The most frequent pulmonary complications of general surgery can be classified as hypoxemia, atelectasis, aspiration of gastric contents, thromboembolism, and respiratory failure in patients with preexisting severe pulmonary disease. Each of these complications is briefly reviewed. HYPOXEMIA The magnitude of hypoxemia following general surgery was first demonstrated by Nunn & Payne (2) in 1962. In a group of normal persons they found the mean arterial oxygen tension (Pao2) while breathing room air to be 58 mm Hg in the immediate postoperative period; the lowest Pao2 recorded was 31 mm Hg. Signifi cant hypoxemia persisted for the 24 hours of study, although no recognized pulmo nary complications such
Annual Review of Medicine – Annual Reviews
Published: Feb 1, 1977
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