Respiratory complications

Atelectasis

• Basal collapse secondary to anaesthetic, abdo incision, post-op narcotics, etc
• If not reopened, alveoli remain full o fsecretions, and pneumonia will occur
• Risk factors:
  • Smokers
  • Obese
  • Copious pulmonary secretions
• Controversial as to whether this actually results in fever
• Treatment is chest physio
  • Incentive spirometry, deep breathing, coughing

Aspiration pneumonitis

• Prevention:
  • Fasting
  • PPI/H2 not shown to be helpful
  • Awake fibreoptic intubation in high-risk individuals
• CXR - infiltrate in posterior segments of upper lobes, apical segments of lower lobes
• If aspiration is witnessed, abx are not indicated immediately unless SBO, or no improvement within 48 hours (treat gram-negatives)

Pleural effusion

• See topic under thoracics