Pulmonary complications in the morbidly obese following jejunoileal bypass surgery under narcotic anesthesia.

The postoperative pulmonary complications detected by chest roentgenogram were correlated with the age, body weight, excess weight/ideal body weight, results of spirometry, arterial blood gas values and duration of anesthesia in 99 obese patients (mean weight 146.8 kg) who underwent jejunoileal bypass surgery under narcotic anesthesia. The overall postoperative pulmonary complication rate was 25.3 per cent. Age, body weight, excess weight/ideal body weight, preoperative vital capacity (VC), VC per cent of the predicted, forced expiratory volume 1 sec. over forced vital capacity (FEV1/FVC) PaO2 per cent of the predicted, PaCO2 and duration of anesthesia were of no value in predicting postoperative pulmonary complications. The presence of associated clinical diseases expected to affect pulmonary function (e.g., chronic bronchitis, congestive heart failure) was the only significant variable in this regard (p less than 0.01). In 85 patients who did not have an associated disease expected to affect pulmonary function, the incidence of pulmonary complication was 20 per cent; the results of spirometry were essentially normal, but the PaO2 was significantly decreased. In 14 patients with an associated disease expected to affect pulmonary function, the incidence of pulmonary complication was 57.1 per cent. The mean VC and mean PaO2 were significantly decreased; the mean age and mean PaCO2 were significantly higher in the group as compared with those in the patients without an associated disease.