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The diagnosis and prophylaxis of pulmonary complications of surgical operation
Laszlo G, Archer GG, Darrell JH, Dawson JM, Fletcher CM
The British Journal of Surgery 1973 Feb;60(2):129-134
clinical trial
2/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: No. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Eighty-eight non-bronchitic and 52 bronchitic patients undergoing elective general and plastic surgical operations in two wards were studied for post-operative chest complications, which were diagnosed by increased purulence of sputum and radiological changes at 24 or 48 hours. Eighty per cent of the patients undergoing upper abdominal surgery and 30% of the other patients had chest complications. Postoperative bronchitis or pneumonia severe enought to delay discharge was found in 14 patients (10%). Twice-daily physiotherapy to the chest did not affect the oucome in 86 patients without chronic bronchopulmonary disease. Routine administration of amicillin to 'cover' chronic bronchitics undergoing general anaesthesia was found to be of no value in a controlled trial of the 52 bronchitic patients. However, bacteriological and radiological studies lend some support to the suggestion that prophylaxis with a bactericidal antibiotic may reduce the indicence and morbidity of post operative pulmonary infections in patients having upper abdominal operations.

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