Complications respiratoires postopératoires

Respiratory complications are common after surgery. Several complex mechanisms such as postoperative diaphragmatic dysfunction, ventilation perfusion mismatching, atelectasis and pulmonary infection are responsible for such complications. Several scoring scales allow to evaluate the risk of postoperative pulmonary complications that depends especially of the surgical procedure performed (upper abdominal and thoracic surgery). Smoking cessation as soon as possible, chest physiotherapy, incitative spirometry and peroperative protective ventilation are the main preventive measures. Postoperative epidural analgesia plays a role but its impact is vanishing with the decreasing incidence of respiratory complications. Non-invasive ventilation, incitative spirometry and physiotherapy need to be maintained postoperatively in patients at risk.