Author/Editor		Sprung, J; Cheng, EY; Nimphius, N; Hubmayr, RD; Rodarte, JR; Kampine, JP
Title		Diaphragm dysfunction and respiratory insufficiency after upper abdominal surgery
Type		članek
Source		Pluć Boles
Vol. and No.		Letnik 43, št. 1-2
Publication year		1991
Volume		str. 5-12
Language		eng
Abstract		This study was designed to determine the contribution of diaphragm dysfunction and pain to respiratory inssuficiency after upper abdominal surgery. Respiratory insufficiency and postoperative pain in humans were evaluated by pulse oximetry, pulmonary function tests, and a visual analog scale. Diaphragm shortening in dogs was evaluated with biplane videoroenthenography. In humans, despite reasonable pain control, pulmonary function, as reflected in forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and arterial oxygen saturation (SpO2) were significantly reduced on the first postoperative day. Improved pain control was not associated with improvements in FVC or FEV1. IN the dogs, diaphragm shortening and tidal volume were significantly reduced in the immediate postoperative period. Phrenic nerve stimulation immediately after surgery resulted in supramaximal diaphragm shortening, which indicated neither the diaphragm nor phrenic nerves were significantly injuried by surgical manipulation. Diaphragm dysfunction has a major role in postopertaive pulmonary insufficiency; an afferent-mediated reflex inhibition of the phrenic nerves may be responsible.
Descriptors		POSTOPERATIVE COMPLICATIONS PAIN SPIROMETRY OXIMETRY ANIMALS, DOMESTIC DOGS ADULT VITAL CAPACITY FORCED EXPIRATORY FLOW RATES RESPIRATORY PARALYSIS ABDOMEN