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March 1962

Preoperative Medical Evaluation of the Respiratory System

Author Affiliations

From the Department of Medicine, Albert Einstein Medical Center, Northern Division, Philadelphia.; Senior Attending Physician (Dr. LeWinn); Associate Physician (Dr. Greenstein), and Attending Physician, Section of Chest Diseases (Dr. Kimbel), Albert Einstein Medical Center.

Arch Surg. 1962;84(3):277-281. doi:10.1001/archsurg.1962.01300210011002

In a previous article1 we have stressed the importance of a careful evaluation of the heart and kidneys in the preoperative patient in order to assure a smooth and uncomplicated surgical procedure and postoperative course. Similar emphasis should be given the preoperative assessment of the respiratory system and those situations which invite postoperative atelectasis and pneumonitis, probably the most common causes of surgical morbidity outside the operative area proper.

Certain factors predispose the surgical patient to postoperative complications involving the bronchopulmonary tissues. They may be divided into 2 groups:

1. Conditions existing in the patient prior to the surgical problem. Of these, the commonest are chronic bronchitis, bronchiectasis, and pulmonary emphysema.

2. Conditions related to the surgical procedure itself or to preparation for it. Here we include surgery in the upper abdomen; casts or dressings applied immediately postoperatively, limiting respiratory excursion and effective coughing; the use of a nasogastric

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