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Breathing pattern and gas exchange in emergency and elective abdominal surgical patients

Abstract

Objective

To evaluate the effecs of intra-abdominal surgical emergency on breathing pattern and gas exchange and compare in with the changes induced by elective abdominal surgery.

Design

Prospective clinical study.

Setting

Abdominal surgical departments in a university hospital.

Patients

Patients operated for intra-abdominal emergency (n=10, EAS), elective upper abdominal (n=19, UAS).

Measurements and results

Breathing pattern and gas exchange were measured with a respiratory inductive plethysmograph and a gas exchange monitor. EAS patients had pre-operatively a classical rapid shallow breathing pattern and increased ventilatory demand due to increased energy expenditure. The operation improved the breathing to normal pattern (frequency, 26±5/min and 17±3/min,p<0.01; tidal volume, 439±128 ml and 541±165 ml, NS., before and after surgery, respectively). Sighing was absent before and after EAS and strictly reduced after elective surgery (p<0.01 for UAS). The operation restricted the abdominal-diaphragmatic breathing movement which was reflected as increased contribution of the rib cage to VT (%RC: from 37%±15 to 57%±15 for UASp<0.001; from 47%±16 to 61%±14 for EAS NS.). After EAS and UAS hypoxemia was common (p<0.001) with frequent radiological pathology. We conclude that intra-abdominal surgical emergencies increase the ventilatory demand and challenge the respiratory system to marked adaptive changes both pre- and post-operatively.

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Correspondence to J. Takala.

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Tulla, H., Takala, J., Alhava, E. et al. Breathing pattern and gas exchange in emergency and elective abdominal surgical patients. Intensive Care Med 21, 319–325 (1995). https://doi.org/10.1007/BF01705410

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Key words

  • Breathing pattern
  • Gas exchange
  • Abdominal surgery