Preoperative Pulmonary Function Testing Predicts Cough Effectiveness Early After Laparoscopic Bariatric Surgery

Abstract

Background:

Cough is a protective mechanism providing bronchial drainage and helps to protect secretion retention in postoperative patients. Although laparoscopic bariatric surgery significantly decreases postoperative respiratory complications, there is an increase in patients with abnormal pulmonary function test results. The aim of the study was to investigate the relationship between preoperative pulmonary function testing (PFT) variables and cough effectiveness early after laparoscopic bariatric surgery.

Methods:

Twenty-seven patients (8 male and 19 female, median age 39 years) who had undergone laparoscopic sleeve gastrectomy were enrolled in the study. Preoperative PFT was recorded from patient files. Cough effectiveness was assessed using a portable flow meter to measure peak cough flow (PCF) on the first postoperative day.

Results:

None of the patients showed an obstructive (median forced expiratory volume in 1 s/forced vital capacity [FEV₁/FVC] ratio was 83%), restrictive (median FVC was 92%), or mixed pattern before surgery. Postoperative median PCF value was 300 L/min that was 68.2% predicted according to normative values. Postoperative PCF showed moderate positive correlations with peak expiratory flow (PEF) and forced expiratory flow at 25–75% (FEF_25–75: rho = 0.500, p = 0.008; rho = 0.440, p = 0.022, respectively).

Conclusion:

Preoperative PFT, specifically PEF and FEF_25–75, predicts cough effectiveness early after laparoscopic bariatric surgery even in patients with normal test results. The patients, especially with abnormal PEF and FEF_25–75, could be encouraged for an effective cough with directed cough maneuvers both in preoperative and postoperative periods.