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March 6, 2019

Does Atelectasis Cause Fever After Surgery? Putting a Damper on Dogma

Author Affiliations
  • 1Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
  • 2Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
  • 3Ghost Lab, Laboratory of Immunogenetics, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland
JAMA Surg. 2019;154(5):375-376. doi:10.1001/jamasurg.2018.5645

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

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