Pulmonary Function and Thoraco-abdominal Configuration After Elective Craniotomy

Background and Purpose The development of pathophysiologic pulmonary alterations are observed after thoracic and abdominal surgeries. The purpose of this article is to report the alterations in the thoracoabdominal configuration and ventilometric parameters that occur during the postoperative period after elective craniotomy. Subjects Forty-seven patients submitted to craniotomy owing to the presence of an aneurysm or tumor, under general anesthesia were analyzed. Methods Tidal volume (TV), respiratory rate, and diaphragmatic index were measured from the preoperative period to the fourth postoperative day and pH, PaCO2, PaO2, and SaO2 to the second postoperative day. Results We observed a decrease in TV, an increase in respiratory rate, increased alveolar ventilation, and a change in the respiratory pattern from predominantly abdominal to predominantly thoracic respiration. Conclusions A decrease in the diaphragmatic index, and a reduction in abdominal motion, associated to a lower TV, is suggestive that the lower parts of the lungs were less ventilated than the higher ones.