ABSTRACT
Cardiopulmonary complications of thoracic surgery in children mirror those in adults in many ways. As in adults, preoperative efforts can prevent complications of surgery. Atelectasis should be discouraged. Smoking in teenage patients should be stopped prior to elective surgery. Asthmatic children should have their disease controlled as well as possible. The numerous medications available for chronic lung disease should be utilized under the direction of a pulmonary specialist to optimize lung function before operation. Intraoperatively, adequate inflation of the lungs by positive pressure ventilation should be assured by looking at the lung at time of closure or completion of thoracoscopy. After operation, pain relief is critical to allowing full opening of the lung. While some degree of atelectasis is a normal postoperative finding, it responds well to incentive spirometry, flutter valve, and other measures for pulmonary toilet. How frequently atelectasis leads to pneumonia is unclear, but not often. Family members can encourage the patient with these measures, and this helps them to realistically feel they are contributing to recovery.
