Pulmonary testing

A reader responds to a recent article about perioperative testing.

I read with interest the article on perioperative management of cardiac and pulmonary patients (“Questions and answers in periop medicine,” January 2018 ACP Hospitalist). I find it intriguing that expiratory flow rate of intubated patients during surgery is used to predict post-op recovery and complications.

When my dad underwent prostate surgery 45 years ago in India, the anesthesiologist who checked him for pre-op clearance tested his breath-holding time and also used a tape measure to check his fully expanded lung at nipple level. Doesn't it correlate well with intubated expiratory flow rate?

I wonder why breath-holding time is not used more frequently in the assessment of pre-op evaluation. My father, being a yogi, had a breath-holding time of more than one minute. Obviously he did very well post-op.

We seem to be coming full circle.

Chakrapani Prakash, MD, FACP
St. Petersburg, Fla.