ABSTRACT
Pulmonary complications have long been recognized as a major postoperative problem. Anesthesia and surgery are common causes of respiratory failure in hospitalized patients with chronic obstructive pulmonary disease (COPD). The incidence of pulmonary complications varies according to the definition of a complication and the severity of lung disease; relative risks range from 2.7 to 4.7 (1-4). The possibility of prolonged postoperative mechanical ventilation support may be of particular concern to patients and physicians. However, most of the studies that have investigated perioperative outcomes in the COPD patients had several limitations. Many studies have not adequately controlled for factors other than airway obstruction, such as site of surgery, comorbid disease, and smoking history, which may contribute to risk. The definition of postoperative pulmonary complications and the definition of chronic lung disease vary considerably among studies. Therefore, most of the applicability of findings form earlier studies to current practice is uncertain.
