How to Prevent Postoperative Pneumonia Without Drugs

How to Prevent Postoperative Pneumonia Without Drugs

This entry was posted in Uncategorized. Bookmark the permalink.
  1. One of the most common postoperative complications is pneumonia, especially if the patient has undergone thoracic surgery (an operation on the chest or back), is non-ambulatory for extended periods (is laying flat on the back like a sack of potatoes), has a compromised immune system (such as patients with AIDS or hepatitis B) or spends too much time in the hospital. And let’s face it: anyone who has been hospitalized will agree that anything more than a day after regaining consciousness is too much time in the hospital. Nosocomial infections (infections acquired within a hospital) happen all the time, despite the valiant efforts of housekeeping staffs to keep their hospitals spic-and-span; and the most common of these is pneumonia.

     Anaerobic bacteria, those that live where there is little or no oxygen, cause most strains of pneumonia. Oxygen is poisonous to these organisms. Many postoperative patients find it difficult or painful to breathe deeply; those who are bedridden often forget to do this or are too out of it to notice. When this happens, the lowest regions of the lungs may get no air, creating a perfect breeding ground for anaerobic bacteria. They feast on mucus and the epithelial cells of the lower airways and compound their numbers, multiplying prodigiously. The next thing you know, you have a fever, are as weak as a kitten and you can’t stop coughing—which is exactly the state you want to avoid if you just had your ribs spread apart in an operation. Now that you are infected, you undergo a prolonged treatment with antibiotics combined with respiratory therapy to clear the gobs of thick, sticky mucus out of your lungs. Trust me: this is no picnic.

    It is always best to avoid complications if possible—and it’s even better if you can do so without the aid of drugs. And believe it or not, pneumonia can be pretty easy to prevent, if you know what to do.

    Air contains about 21% oxygen, the worst enemy of anaerobic bacteria. Therefore, you want to keep air circulating through the lowest regions of your lungs as much as possible. That way, the bacteria—which may always be in your lungs, and mine and that other guy’s, too, because they are “normal flora” (meaning bacteria that are always present but usually do no harm)—won’t have a chance to multiply.

     Virtually any American hospital will give you a device called an Incentive Spirometer (I.S.) following many types of surgery. If a nurse or doctor gives it to you, they may give only basic instructions on its use without explaining how important it is to use it. Respiratory Therapists are trained to instruct patients in the proper use of I.S. devices. Unfortunately, many RTs are either too busy or lack the will to spend the time teaching their patients a seemingly mundane thing. I used to piss off a lot of my fellow RTs, because I always took spirometry very seriously, providing an example some of them were loathe to follow.

     The Incentive Spirometer encourages deep breathing by challenging the patient to raise a plastic wafer or plastic balls to certain preset levels of achievement. However, one need not use an I.S. to breathe deeply and prevent postoperative pneumonia. It’s very simple, actually. All you need to do is take a deep breath, inhaling slowly, until your lungs can hold no more air—and then breathe in some more. Doing this five to ten times every hour or two is usually enough to prevent many strains of pneumonia. Unfortunately, it can’t prevent them all, but it still doesn’t hurt.

    Some wise, fat Founding Father once said that an ounce of prevention is worth a pound of cure. I’ll bet old Ben never had postoperative pneumonia.

Leave a Reply