• Postoperative Respiratory Failure

    Following surgery, serious pulmonary complications such as respiratory failure can delay, or even prevent, complete recovery. In order for physicians to apply necessary preventive and/or interventional treatments, careful monitoring in the post-surgical setting is absolutely critical.

    Respiratory failure results in the failure of the lungs to properly complete one or both of its main tasks: taking in oxygen from the air and getting it into the bloodstream; and eliminating carbon dioxide (CO2) from the blood through air that is exhaled. When the former is the case, the level of oxygen in the blood becomes dangerously low, and when the latter is the problem, the level of CO2 becomes dangerously high.

    Patients at particularly high risk of developing a serious pulmonary complication such as respiratory failure in the postoperative setting include those who:

    • Underwent coronary artery bypass grafting (CABG), thoracic surgery, or procedures on the head and neck
    • Reacted adversely to a particular anesthetic agent
    • Experienced a high-level spinal cord injury or severe head trauma
    • Have chronic lung disease (e.g., asthma or bronchitis)
    • Actively smoke or have a history of smoking
    • Are obese

    Shortness of breath is one of the most common signs of respiratory failure, along with confusion and disorientation caused by the low level of oxygen and the high level of CO2 in the blood. In hypoxemic respiratory failure, the type whereby enough oxygen is not inhaled from the air and carried into the bloodstream, additional symptoms may include a bluish appearance of the skin and an abnormal heartbeat. With ventilatory failure, when CO2 from the blood is not adequately eliminated through air that is exhaled, further signs may include headache and a semi-conscious state or coma.

    Treatment of postoperative respiratory failure begins with the administration of oxygen, and from there, the underlying source of the problem is then treated (e.g., antibiotics administered to treat a lung infection). If breathing remains weak after the cause of the respiratory failure has been targeted and treated, the patient will require the aid of a ventilator to help with breathing. Once the patient has been sufficiently stabilized, a respiratory therapist can aid in the recovery process by using techniques such as lung suctioning and postural drainage to help remove excess fluids from the airways and lungs, and by demonstrating breathing exercise to help the patient regain strength in those muscles involved in breathing. 

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