Hypoxaemia after Partial Gastrectomy

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Abstract
The effect of partial gastrectomy on arterial O2 saturation, blood gas tensions, alveolar-arterial O2 tension gradients, and physiological dead-space/ tidal volume ratios was studied in 10 patients. Five had no complications, but 5 developed clinical and radiological evidence of pulmonary collapse. The changes were similar in both groups, but were slightly more marked in the complicated group. There was slight arterial hypoxemia lasting at least 5 days, especially during the first 3 postoperative days, but there was no evidence of overall alveolar hypo-ventilation as the arterial PCO2 levels were normal. In both groups, the hypoxemia was associated with a proportionate increase in the alveolar-arterial O2 tension gradient, and physiological dead-space/ tidal-volume ratios were also increased somewhat before and after the operation, presumably due to overventilation. It was concluded therefore that hypoxemia after operations arises as a result of disturbances of the normal ventilation to perfusion relationships within the lung. These changes are unlikely to be of significance to patients in good health but may be of significance to older patients and when there is cardiac, respiratory or cerebrovascular disease.