Perioperative management of the patient with respiratory disease

Respiratory complications are common, representing 10% of all postoperative complications and accounting for significant morbidity, mortality and financial cost. Patients with respiratory disease can be identified preoperatively from a clinical history. Preoperative evaluation should focus on diagnosis and medical optimization of the patient's physical status. Risk stratification of patients allows counselling and consent, planning of perioperative care including anaesthetic management and possible modification of surgical procedure to reduce risk. The aim of the perioperative period is successful surgery without postoperative respiratory complications. Patients should be monitored and complications actively sought and promptly treated to reduce their impact and increase the likelihood of a good outcome. Postoperative level 2 or 3 care allows for the more rapid detection of physiological disturbance and prompt treatment.