Cardiorespiratory effects of laparotomy in patients with spinal cord injury.

Patients with spinal cord injuries who require laparotomy are often difficult to diagnose and have an acute illness superimposed on a background of respiratory and cardiovascular abnormalities. Although pulmonary capacity is markedly reduced by paralysis, these patients tolerate elective laparotomy well. Emergency surgery for abdominal infection led to cardiac instability in two patients and prolonged respirator support in a third. This series of 12 patients supports elective colostomy for colon and perineal problems in these patients, even those with poor ventilatory volumes. Emergency surgery was marked by dramatic cardiovascular problems, which were corrected with pulmonary artery pressure monitoring of fluid resuscitation.