Certain measures may help to reduce perioperative pulmonary complications. These are: stopping smoking, preoperative inhaled P-agonists for patients with COPD, or intravenous steroids if needed, the use of regional anaesthesia (with or without general anaesthesia), and lung expansion exercises postoperatively. Morbidly obese patients (> 115 kg or 250 lb) and smokers are twice as likely to develop postoperative pneumonia.
Assessment of patients with other problems may be required. Impairment of any organ system leads to an increase in perioperative complications. Endocrine disorders (for example, diabetes), renal failure, liver disease, haematological, and neurological disorders are not discussed here. Other scoring systems have been developed that assist in the assessment of risk prior to surgery, for example the Child-Pugh classification of liver disease.
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