Fever and atelectasis are common after surgery, and in the absence of infectious causative mechanisms, atelectasis is commonly thought to be a cause of fever. The notion is entrenched in surgical textbooks and frequently discussed on morning rounds in the hospital. The therapeutic implication of atelectasis as a putative cause of postoperative fever has been the widespread adoption of incentive spirometry to reduce atelectasis.
Despite the ubiquity of this view, evidence that atelectasis is a cause of fever is scarce; indeed, many studies have failed to demonstrate an association between fever and atelectasis.1 Moreover, in several randomized clinical trials, incentive spirometry has not been shown to reduce the incidence of fever.2