Respiratory status of adult patients in the postoperative period of thoracic or upper abdominal surgeries.
Alana Gomes de Araujo Almeida, Lívia Maia Pascoal, Francisco Dimitre Rodrigo Pereira Santos and 3 others
PMID 29211198WHAT IT FOUND
In adults after thoracic or upper abdominal surgery, coughing, abnormal breath sounds and respiratory-rate compromise were the most common respiratory assessment findings, each rated compromised in more than 50% of assessments.
Key findings
01Coughing, auscultated breath sounds, and respiratory rate were the most compromised respiratory-status indicators, each rated at some level of compromise in more than 50% of assessments.
02General anesthesia was related with increased chance of compromised somnolence, chest retraction, dyspnea with mild exertion, diaphoresis, and accessory muscle use.
03Patients with pain had more compromised dyspnea with mild exertion and auscultated breath sounds; patients without pain had less compromised respiratory rhythm; patients with pain had less compromised cyanosis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in one tertiary hospital in northeastern Brazil, so it may not apply to other settings. Patients were assessed only once, in the first 48 hours after surgery, and patients with gastric-tube feeding, tracheostomy, or serious cognitive impairment were excluded. Data were collected by different undergraduate nursing students, so assessment variability may have occurred despite training. Some patients could not answer and relatives provided information, which may affect reliability. The design is cross-sectional and reports bivariate associations, so it cannot show that pain, age, gender, or anesthesia caused respiratory compromise. The paper says all patients had normal vital parameters, but Table 1 reports oxygen saturation as low as 61%, making the vital-sign interpretation unclear.
Declared interests
No funding or conflict-of-interest declaration is provided in the supplied text.
The easy way to misread this
Do not read the associations with pain, age, gender, or anesthesia as proof that those factors caused respiratory compromise. The study assessed patients at one time point and reports bivariate associations.