Anesthesia and the stress of surgery can cause complications that are sometimes life-threatening. Patients are monitored during and after surgery for early signs of complications related to immobility or to the procedure. Signs of shortness of breath, also called dyspnea, in a postoperative patient requires immediate evaluation and intervention, according to Carol Taylor, author of the 2008 nursing textbook, "Fundamentals in Nursing." Elderly patients, as well as those in poor general health, smokers and those who have undergone abdominal or chest surgery are most likely to develop shortness of breath.
Pulmonary Embolus
A pulmonary embolus is a serious complication of bed rest or surgery that requires emergency treatment. When a blood clot forms in the legs, as may occur during lengthy surgical procedures or prolonged bed rest after surgery, it can break off and travel to the lungs, suddenly blocking the pulmonary artery, according to the Merck Manual. An embolus--called a fat embolus--can also form when a long bone is fractured or repaired surgically. (Ref. 2) Sudden shortness of breath is the most common symptom of an embolism. Rapid respirations, chest pain, anxiety, confusion, lightheadedness or fainting may also occur. If the embolism is large, the patient may suddenly go into shock and die. Treatment includes medication to dissolve the embolism and, sometimes, surgical removal.
Atelectasis
Shortness of breath is the only symptom of atelectasis, a condition in which part or all of a lung becomes airless and collapses, according to the Merck Manual. Atelectasis occurs when the bronchial tubes--the tubes that branch from the trachea or windpipe into the lungs--are blocked with mucous, a foreign body, a tumor or enlarged lymph nodes. Under normal circumstances, coughing and deep breathing keep the bronchial tubes open, but anesthesia suppresses those urges. Abdominal and chest surgical procedures also make coughing and deep breathing painful, increasing the likelihood of atelectasis. Postoperative patients are instructed to use a spirometer--device that encourages deep breathing--and to cough every hour after surgery to keep their lungs expanded.
Aspiration Pneumonia
Aspiration pneumonia is a lung infection caused by inhalation of mouth secretions or stomach contents, according to the Merck Manual. Although secretions and droplets are often inhaled, the healthy body clears them by coughing them out before they enter the lungs. Elderly, debilitated, postoperative or sedated patients are at highest risk for aspiration pneumonia as their ability to cough effectively is suppressed. Symptoms of aspiration pneumonia include cough and shortness of breath. Treatment includes antibiotics for the infection, coughing, deep breathing and respiratory therapy.
References
- Merck Manuals Online Medical Library: Atelectasis
- Merck Manuals Online Medical Library: Pulmonary Embolism
- "Fundamentals of Nursing;" Carol Taylor; 2008
- Merck Manuals Online Medical Library: Aspiration Pneumonia
