Incidence of Contralateral Pulmonary Atelectasis After Thoracotomy; An Evaluation of Preventive Aftercare

¹ Department of Surgery, Thoracic Surgery Service and Department of Radiology, Valley Forge General Hospital

A comparative investigation of the incidence of contralateral roentgenographic pulmonary atelectasis was made in three groups of post-thoracotomy cases. The first 84 cases received adequate aftercare with good tracheobronchial toilet without emphasis on mucolysis. The second 84 cases received acetylcysteine administered by direct intratracheal instillations in 10 per cent concentration in addition to accepted aftercare. The third group of 30 cases received the mucolytic agent administered by intermittent positive pressure breathing apparatus. The incidence of contralateral pulmonary atelectasis for the total series of cases was 14 per cent and did not vary significanty between the groups studied. The incidence of atelectasis is recognizably related to moment by moment supervision of tracheobronchial toilet after thoracotomy, rather than a specific technique or therapeutic agent. However, the addition of acetylcysteine may be a valuable adjunctive agent to promote easier and more rapid elimination of undesirable secretions.