Abstract
Based on recent 7 elderly cases (2 males and 5 females aged 80-88) those required artificial ventilation management after emergency abdominal surgery, the indications and usefulness of postoperative respiratory management were evaluated. Diagnosis were as follows: 2 bowel obstruction cases caused by small intestinal adhesions, 1 perforated duodenal ulcer case, 2 colonic or rectal cancer cases with perforation, 1 superior mesenteric artery obstruction case and 1 intraperitoneal abscess case. The etiology of postoperative respiratory dysfunction included respiratory failure due to shock and electrolyte abnormality, and the postoperative artificial ventilation management period was 2 to 99 days. Patients with a postoperative PaO2/FiO2 ratio of less than 200 required a longer artificial ventilation accompanying pneumonia, pleural effusion and SIRS. The cases with superior mesenteric artery obstruction and with intraperitoneal abscess died. The PaO2/FiO2 ratio just after surgery was useful for the prognosis of postoperative artificial ventilation management. When the pathologic condition is eliminated by operation and postoperative treatment, the prognosis of the elderly patient with prolonged artificial ventilation might be better.
