Pre Op Pulmonary Function Management - Wheeless' Textbook of Orthopaedics

- 2-7 days before surgery; - w/ spirometry, measure the response with bronchodilators; - w/ thoracic surgery: FEV1 < 50% = high risk - w/ peripheral surgery FEV1 < 30% = high risk - FEV1/FVC ratio of less than 0.5 - pCO2 > 45 (and patient is not receiving meds that decrease ventilation abdominal or thoracic operations) carry life threatening risk of pulmonary complications; - Perioperative Prophylactic Pulmonary Maneuvers: - stop smoking, administer ATB for purulent sputum, bronchodilators, PT - bronchodilators - chest PT and postural drainage - education & post op use of INS & deep breathing exercises; - perioperative antibiotics if sputum is purulent - early post op ambulation;