Lung expansion interventions fail to reduce breathing problems after abdominal surgery

A new study, published today in The Lancet Respiratory Medicine, tested whether a set of interventions to keep lungs expanded before, during, and after abdominal surgery could lower the risk of serious breathing problems in patients compared to the usual care at 17 academic hospitals in the U.S. The research has determined that these interventions for open abdominal surgery do not result in less severe breathing problems as compared to the usual care in those hospitals.

Adult abdominal surgery patient enrollees were either given a lung expansion set of interventions or the typical care plan to follow at each hospital. The study, which was designed at the Massachusetts General Hospital (MGH) and the University of Colorado Anschutz Medical Campus, found no major difference in lung complication severity between those who received the lung expansion interventions and those who received usual care.

Researchers tracked a wide range of problems for ninety days after surgery, from mild issues like slightly low oxygen levels, to more serious problems as pneumonia, up to need for assistance from a breathing machine, and found that both groups had similar results. Reduced lung function can make recovery more difficult and increase the risk of serious complications. Many patients struggle with breathing problems after abdominal surgery, which can lead to prolonged hospital stays, infections, or even respiratory failure if not properly managed.

This is why improving care around surgery is crucial. Our results show that while these interventions helped avoid rescue treatments for poor oxygenation during surgery, they were not enough to make a big difference after surgery. This means anesthesiologists, surgeons, nurses, and respiratory therapists need to work together to find better ways to care for patients' lungs."

Ana Fernandez-Bustamante, MD, PhD, professor at the University of Colorado Anschutz Medical Campus and study co-author

Current usual care in US academic hospitals was not known. This study revealed that doctors in US academic hospitals already try to keep patients' lungs moderately expanded in their usual care, despite unclear international advice.

"Many patients had lung complications after surgery in our study. Since these complications put patients at risk of more health problems, longer hospital stays, and higher healthcare costs, it's important to keep researching better ways to prevent them," said Marcos F. Vidal Melo, MD, PhD, Professor and Chair of Anesthesiology at the University of Texas Medical Branch and study co-author. Dr. Vidal Melo was at the MGH when the study started. "The costs associated with treating these complications are in the order of billions of dollars. We'll have to think outside the box to prevent them. Our findings show that lung complications are still a pressing concern, and we need to continue to work on better lung care for patients during and after surgery."