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Postpneumonectomy pulmonary oedema.

L Verheijen-Breemhaar1, J M Bogaard, B van den Berg

  • 1Department of Pulmonary Diseases, University Hospital Dijkzigt, Rotterdam, The Netherlands.

Thorax
|April 1, 1988
PubMed
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Pulmonary oedema occurred more often after right-sided pneumonectomy and repeat thoracotomy. Positive postoperative fluid balance was a key factor in developing this complication.

Area of Science:

  • Cardiothoracic Surgery
  • Pulmonary Medicine
  • Critical Care Medicine

Background:

  • Pneumonectomy, the surgical removal of a lung, can lead to serious postoperative complications.
  • Pulmonary oedema is a known, albeit infrequent, risk following major thoracic surgery.

Purpose of the Study:

  • To investigate the incidence and risk factors for pulmonary oedema after pneumonectomy.
  • To identify patient and procedural characteristics associated with the development of this complication.

Main Methods:

  • Retrospective analysis of 243 patients undergoing pneumonectomy between 1975 and 1984.
  • Comparison of preoperative pulmonary function, lung scans, cardiovascular status, and postoperative fluid balance between patients who developed pulmonary oedema and those who did not.

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Main Results:

  • Pulmonary oedema occurred in 8/113 (7.1%) right pneumonectomies and 3/130 (2.3%) left pneumonectomies.
  • The complication was more frequent in patients requiring a second thoracotomy for bleeding (3/7 patients).
  • No significant preoperative differences were found; however, a more positive postoperative fluid balance was observed in patients with pulmonary oedema.

Conclusions:

  • Right-sided pneumonectomy and repeat thoracotomy are associated with an increased risk of pulmonary oedema.
  • Positive postoperative fluid balance is a significant contributing factor to the development of pulmonary oedema post-pneumonectomy.