Three tests of pulmonary function were performed in 63 preoperative patients selected at random from a ward service. Among 33 patients whose preoperative pulmonary function was normal, there was one postoperative pulmonary complication; in 30 patients classified as abnormal, there were 21 complications. Decreased maximal expiratory flow rates had the best correlation with respiratory complications. Elevated alveolar carbon dioxide tension was of great significance, and the nitrogen meter single-breath test was also helpful. Location of the surgical incision and age of the patient were other important factors in determining the development of postoperative pulmonary complications. This study demonstrates that a few selected tests of pulmonary function can be helpful to the surgeon and anesthetist in the selection of patients for operation and in indicating the need for preoperative and postoperative prophylactic measures.
Stein M, Koota GM, Simon M, Frank HA. Pulmonary Evaluation of Surgical Patients. JAMA. 1962;181(9):765–770. doi:10.1001/jama.1962.03050350027006
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