Postoperative Pulmonary Complications

The literature dealing with the case incidence of pulmonary complications occurring after operation reveals a wide range in the reported data. For example, Cutler and Scott' collected 41,368 operative cases, from the records of eight dinics, with an incidence of 1.12 per cent of postoperative pneumonia. Many other reported series approximate this percentage. On the other hand, in 1930, Fuller,2 after a personal observation of early and late pulmonary complications in 1,478 consecutive operative cases, reported 22.6 per cent in upper abdominal operations and 10.9 per cent in lower abdominal procedures. In 1933, King3 published the most complete survey to date based upon personal observation in a large series of operations with even higher morbidity percentages. He pointed out the fallacy of data determined only by the review of case records or hospital diagnosis files, and inferred that observations should be made postoperatively, at the bedside, by an interested observer working continuously throughout the period of study. Thus fluctuations in diagnostic standards were minimized and errors of omission more nearly eliminated. Additional surveys such as King's are indicated because of the marked discrepancies in morbidity figures previously mentioned. It is especially important to gain groups of control data fromn various clinics if the prophylactic and therapeutic effects of various agents, such as carbon dioxide, are to be adequately evaluated. In this report we have followed King's definition and criteria of postoperative pulmonary disease, the data being confined to those cases of bronchopneumonia, lobar and lobular atelectasis, and post-atelectatic pneumonitis which develop during the first few postoperative days. Pulmonary embolism and empyema are