Clinical Significance of FEV1.0 to Predict Post Operative Pulmonary Complication |
Mi Kyeong Kim, O Jung Kwon, Choon Taek Lee, Sang Heon Cho, Sung Koo Han, Young Soo Shim, Keun Youl Kim, Yong Chol Han |
Department of Internal Medicine, College of Medicine, Seoul National University, Tuberculous Research Institute, Seoul, Korea |
수술후 폐 합병증의 예견지표로서의 FEV1.0의 평가 |
김미경, 권오정, 이춘택, 조상헌, 한성구, 심영수, 김건열, 한용철 |
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Abstract |
To evaluate the risk factors of post-operative pulmonary complications, we reviewed 166 cases who underwent surgery under general anesthesia except chest surgery. All of them had value of FEV1.0
below 1.5 L. Post-operative major pulmonary complications such as pneumonia, acute respiratory failure and pulmonary embolism occurred in only 2 cases among 166 patients. Parameters of pulmonary function test including FEV1.0, % predictive value of FEV1.0, and FEV1.0/ FVC were compared with the occurrence of major pulmonary complications and age of patients, smoking history, site of operation and duration of operations were also compared.
Results were as follows:
1) There were only 2 post-operative major pulmonary complications and both were post-operative pneumonia.
2) Value of FEV1.0 of patients with major pulmonary complication were 1. 1 L and 0.74 L respectively, and % predictive value of FEV1.0 and FEV1.0/ FVC of them were below 35%.
3) Age of patients with major pulmonary complication were 63 and 64 years old respectively. But there was no major pulmonary complication among patients even over 70-years-old.
4) Both patients with major pulmonary complications underwent upper abdominal surgery, especially operation of biliary tract.
5) Duration of operation in patients with major pulmonary complication was less than 3 hours.
6) Both patients with major pulmonary complication had smoking history over 8 years and both had smoked until the date of operation From above data, though careful prospective study is needed, we might conclude that occurrence of post-operative major pulmonary complications correlated with preoperative poor pulmonary function tests (FEV1.0 less than 1.2L % predictive value of FEV1.0; less than 35%, FEV1.0/FVC less than 35%). But % predictive value of FEV1.0 and FEV1.0/ FVC were possibly more accarate than absolute value of FEV1.0 to predict the post-operative major pulmonary complications. Above criteria were not absolute contraindication to major surgery under general anesthesia and multiple faclurs of patients status should be considered. |
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