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Sepsis in the Postpneumonectomy Space: Pathogenesis, Recognition, and Management
1University of Ottawa, General Campus, Ottawa Hospital, 501 Smyth Road, Ottawa, Ontario K1H 8L6, Canada.
Abstract:
Empyema may occur in the pleural space after pulmonary resection. Subsequent bacterial contamination results in infection and development of frank empyema. Pneumonectomy-surgical removal of the entire lung-is the treatment of choice for centrally located bronchogenic carcinoma, diffuse malignant mesothelioma, and chronic inflammatory lung diseases with destroyed lung from pulmonary tuberculosis, fungal infections, and bronchiectasis. In the uncomplicated case, on the pneumonectomy side, the diaphragm becomes elevated as the air-fluid level decreases with chest wall deformation and gradual disappearance of hydrothorax. The pneumonectomy space is at potential risk for getting infected from bacterial contamination and developing empyema.
Insights
Pneumonectomy, the surgical removal of an entire lung, can lead to pleural space infection known as empyema. This risk arises from potential bacterial contamination within the pneumonectomy space following the procedure.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Infectious Diseases
Background:
- Empyema, a pleural space infection, can complicate pulmonary resection surgeries.
- Pneumonectomy is a critical procedure for conditions like lung cancer and chronic lung diseases.
Purpose of the Study:
- To describe the potential for empyema development in the pleural space post-pneumonectomy.
- To highlight the risk factors and clinical course of post-pneumonectomy empyema.
Main Methods:
- Review of clinical cases and outcomes following pneumonectomy.
- Analysis of the pathophysiology of pleural space infection after lung removal.
Main Results:
- The pneumonectomy space is susceptible to bacterial contamination and subsequent empyema formation.
- Uncomplicated cases show diaphragm elevation and hydrothorax resolution, but infection risk remains.
Conclusions:
- Post-pneumonectomy empyema is a significant complication requiring awareness.
- Monitoring the pneumonectomy space for infection is crucial for patient outcomes.
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