The assessment of patients with lung disease

Preoperative lung function tests and arterial blood gases can predict the need for postoperative ventilatory support and quantify the type and degree of respiratory impairment. High risk patients include those who are breathless at rest, have a

PaCO2 > 6 0 kPa (46 mmHg), FEV1 > 1 litre, or an FEV1/FVC ratio of < 50%. Other factors which make pulmonary complications more likely include:

• upper abdominal or thoracic surgery (closer to the diaphragm carries higher risk)

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