Safety of performing Spirometry in patients with Abdominal Aortic Aneurysm (AAA )and the utility of Forced Expiratory Volume in first second (FEV1) in predicting length of postoperative hospital stay

2017 
Introduction: AAA is cited as a relative contraindication for spirometry in 1996 AARC document. However, it can be a predictor of outcome of surgery. Objectives: The objectives are to: 1. Evaluate the safety of performing forced spirometry manoeuvre in patients with AAA and especially in those with an aneurysm of >/= 6 cm diameter. 2. Evaluate whether there is a correlation between FEV1 and length of post operative hospital stay. Method: An audit was performed on 44 patients with AAA for documented adverse events during and after spirometry. 27 patients who underwent AAA repair were evaluated for correlation of pre operative FEV1 to duration of post operative hospital stay. Results: The median age was 75+/-8.4 (35 males and 9 females). The mean size of aneurysm was 6.2+/-1.03 and 26 patients had AAA size of >/= 6 cm. Spirometry results were normal in 16 patients and airflow obstruction was present in 27 patients and one patients had restirctive lung disease. There was no adverse event documented during or after spirometry in any patient. Of the 27 patients, 13 had Endovascular – bifurcated prosthesis, 3 had aorto – aortic tube graft and 11 had aorto – biiliac graft.Patients9 length of hospital stay (median 8 days) was inversely associated to FEV1 measured pre operatively (r=-0.075, p= 0.010). Conclusion: We conclude spirometry can be safely performed in AAA patients including large aneurysm size of >6 cm in diameter. FEV1 is a good predictor of length of post operative hospital stay.
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