Occasional review
Surgery and the respiratory muscles
a Department of
Thoracic Medicine, b Intensive Care Unit, c University of Crete Medical School,
71110 Heraklion, Crete, Greece
Correspondence to: Professor N M Siafakas.
Received 13 August 1998; Returned to authors 15 October 1998; Revised version received 14 December 1998; Accepted for publication 21 December 1998
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
Respiratory muscles are the only skeletal muscles vital to
life. Surgical procedures can affect the respiratory muscles by a
number of pathophysiological mechanisms including thoracoabdominal mechanics, reflexes, neuromechanical coupling, and loss of muscular integrity. Impairment of respiratory muscle function after surgery may
lead to postoperative complications such as hypoventilation, hypoxia,
atelectasis, and infections, some of which may be life threatening. In
this paper we review surgery that impairs the function of the
respiratory muscles
namely cardiac, thoracic, and upper abdominal
surgery. Therapeutic interventions or protective measures for
respiratory muscles during or after each type of surgery are also
briefly addressed. Lung transplantation and lung volume reduction
surgery are discussed, since both have been shown to improve the
function of respiratory muscles, and possible pathophysiological mechanisms are reviewed. The preoperative assessment of respiratory muscle function is also considered. Furthermore, when postoperative pulmonary complications occur it is worth considering whether the cause
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