Atelectasis and Post Operative Fever

“Atelectasis is a common cause of post-op fever”

Thankfully I personally have yet to be pimped on this particular topic, but I have heard it from the lips of Interns, R2s and even an attending. At the time it seemed a simple enough clinical pearl to store for future use, so I did.

I will have to give credit to Mark Crislip’s post on SBM for alerting me to this falsehood I picked up somewhere in my Internal Medicine rotation. I did a little more digging and true enough it seems to be yet another bit of misinformation that caught itself a foothold in the oral traditions of of clinical dogma in medical education. It is even repeated in several surgery textbooks. (Sabiston amongst them)  

The origins of this oft repeated false pearl probably have something to do with the frequency of post operative fever (which often never has an obvious source) and the ubiquity of post-op atelectasis which can have an incidence of up to 90%.  Somewhere along the line a causal relationship was hypothesized and was stuck without a thorough evaluation. There are numerous papers refuting the hypothesis (I have provided the two most recent below) yet budding young medical students continue to be quizzed on it as if it were gospel.  



Chest.  2011 Aug; Vol. 140 (2), pp. 418-24. Atelectasis as a cause of postoperative fever: where is the clinical evidence? PMID: 21527508

Chest.  2012 Jan; Vol. 141 (1), pp. 274-5; author reply 275; Edict of Postoperative Fever and Atelectasis PMID: 22215840


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October 19, 2012 · 11:59 pm

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