Incidence of contralateral pulmonary atelectasis after thoracotomy; an evaluation of preventive aftercare.

CONTINUOUS E F F I C I E N T TRACHEOBRONchid toilet after thoracotomy is universally recognized as an important feature of patient care to promote rapid mcovery of respiratory stability and prevent complication. This is accomplished by unhesitating application of vigorous methods to stimulate f q u c n t cough and deep breathing. The contrast between the aggmsive attitude toward respiratory economy of the post-thoracotomy patient and the sometimes semi-neglectful attitude toward the postseliotomy patient, may be strilingly demonstrated by the incidence of roent.genographic atelectasis occumng in these two groups of surgical patienh A p d i inary pmspectivc roentgenographic survey of abdominal surgery cases attended at this hospital revealed a 50 per cent inddence of pulmonary atelectasis.' This unacceptably high rate of pulmonary complication was favorably influenced by adoption of an aggressive preventive attitude which included administration of the mucolytic agent acetylcysteine. By i m p k o n , the incidence of poet-thoracotomy atelectasis did not seem to be alarming; however, this investigation was undertaken to more accurately determine the rate of occurrence, and to the clinical usefulness of the mucolytic agent, acetylcysteine, employed an adjunct in management of thoracic surgical patients.