Classification of postoperative pulmonary complications and its management in patients with lung cancer

Autor:	Jumpei Hashimoto, Hajime Maeda, Kiyoshi Ohno, Yasunaru Kawashima, Akihide Matsumura, Takatoshi Mizuta, Shinichiro Miyoshi, Katsuhiro Nakagawa, Kazuya Nakahara
Rok vydání:	1987
Předmět:	Mechanical ventilation medicine.medical_specialty business.industry medicine.medical_treatment Postoperative complication Atelectasis medicine.disease Obstructive lung disease Pulmonary function testing Surgery FEV1/FVC ratio Anesthesia medicine Aminophylline Lung cancer business medicine.drug
Zdroj:	The Journal of the Japanese Association for Chest Surgery. 1:13-19
ISSN:	1884-1724 0917-4141
DOI:	10.2995/jacsurg1987.1.13
Popis:	The postoperative courses in 157 patients with lung cancer were classified into 4 groups : no postoperative problems (Group I, 116 patients), retention of sputum and/or atelectasis requiring bronchofiberscopy more than 2 times (Group II, 17 patients), tracheostomy and mechanical ventilation for more than 2 days (Group III, 14 patients) and postoperative death (Group IV, 10 patients). Pulmonary function study such as FEV1%, MVV/BSA, RL/TLC, ΔN2% and so on revealed that over the one-third of the patients suffered from chronic obstructive lung disease (COLD) of any degree and the frequency of COLD was significantly high in Group II_IV, compared with Group I.Predicted postoperative Index (predicted postoperative FEV1/normal VC) was 56.1+ 15.0% in Group I, 47.1+8.0% in Group II, 31.0+8.4% in Group III and 38.1+16.0% in Group IV, indicating a statistically significant difference between each group except for between Group III and IV.The postoperative epidural buprenorphine was effective in 90.1% of the patients. Parameters of expiratory function expressed as FVC, FEV1, PEFR, maximum expiratory pressure, cough pressure became significantly better after buprenorphine injection.The postoperative aminophylline injection (6 mg/kg 30 min) was effective to increase maximum transdiaphragmatic pressure significantly.We conclude that COLD was an important factor of postoperative risk, and that patients with predicted postoperative Index less than 30% was high risk for postoperative complication. Postoperative epidural anesthesia and aminophylline were useful for postoperative management.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::568c2a77f9b88b81c3bde25b51a4385d https://doi.org/10.2995/jacsurg1987.1.13 Zobrazit plný text záznamu