Who Needs Preoperative Pulmonary Testing Prior To Noncardiothoracic Surgery?

Terry Shaneyfelt, MD, MPHAssoc. Professor, UAB Department of Medicine

Almost No One!

http://bit.ly/18F2MlK

“Preoperative spirometry and chest radiography should not be used routinely for predicting risk for postoperative pulmonary complications.” ACP guideline 2006

Pulmonary Function Testing Isn’t Very Useful But The Data is Limited

Chest Xrays Rarely Change Management

• Preoperative PFTs should be limited to patients…• In whom clinical evaluation cannot determine if COPD

or asthma is at baseline and/or maximally optimized• Unexplained dyspnea• No FEV1 precludes surgery

• CXRs rarely influence management and should be limited to patients….• Known cardiopulmonary disease• ≥ 50 yrs of age undergoing upper abdominal, thoracic,

or AAA surgery

Summary