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Pre Op Pulmonary Function Management


- 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