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Changes of pleural pressure after thoracic surgery
Jin San Bok1, Geun Dong Lee1, Dong Kwan Kim1
1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Journal of Thoracic Disease
|September 4, 2018
Summary
This study measured pleural pressure after pulmonary resection, finding significantly lower negative pressures in lobectomy patients compared to minimal resection patients, especially during deep inspiration. These findings are crucial for understanding lung mechanics post-surgery.
Area of Science:
- Thoracic Surgery
- Pulmonary Physiology
- Respiratory Mechanics
Background:
- Pleural pressure is vital for lung expansion.
- Limited data exists on pleural pressure post-pulmonary resection.
- Understanding these changes is key for patient recovery.
Purpose of the Study:
- To directly measure pleural pressure in patients undergoing pulmonary resection.
- To compare pleural pressure values based on the extent of resection (lobectomy vs. minimal/no resection).
- To analyze pleural pressure during different respiratory phases and actions.
Main Methods:
- Developed a high-resolution digital manometer for direct pleural pressure measurement.
- Enrolled 43 patients: 23 lobectomy, 20 minimal/no resection.
- Recorded maximal, minimal, and mean pleural pressure during quiet breathing, forced breathing, and coughing.
Main Results:
- Lobectomy patients exhibited significantly lower mean pleural pressure during quiet breathing (-11.2 cmH2O vs. -8.3 cmH2O).
- During forced respiration, all pleural pressure values were significantly lower in the lobectomy group.
- Maximal pressures during coughing showed no significant difference between groups.
Conclusions:
- Direct measurement of pleural pressure is feasible using a digital manometer.
- Lobectomy significantly reduces pleural pressure compared to minimal/no resection, particularly during deep inspiration.
- Findings highlight altered respiratory mechanics after lobectomy.
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