Predictors of post-pneumonectomy respiratory failure and ARDS: usefulness of normalized pulmonary artery diameter

Normalized Pulmonary Artery Diameter Predicts Occurrence of Postpneumonectomy Respiratory Failure, ARDS, and Mortality

“…A high number of consecutive patients undergoing pneumonectomy in a single institution, and whose pre-operative scan was available, were evaluated. To our knowledge assessment of PAD as a predictor of outcome in lung cancer patients requiring pneumonectomy has not been reported so far, except in our pilot study [19]. Main limitation of the present study relies in its retrospective character despite the small number of patients with missing data.…”

“…Comorbidities are known to be associated with a higher risk of postoperative respiratory complications [9]. Postoperative pneumonia is the most frequent complication leading to respiratory failure; of note the occurrence of postpneumonectomy pneumonia is associated with comorbidities, suggesting that comorbidities may predispose to pneumonia, which in turn may evolve toward respiratory failure, ARDS, and death [15][16][17][18][19][20][21][22][23][24][25]. Of note, comorbidities are also associated with a higher risk of postoperative bleeding and need for transfusion, which are well-known risk factors for ARDS.…”

“…Measure of diameters was carried out in a semiautomatic manner by using the measurement tool of the Carestream software (Carestream Health Inc., Rochester, NY, USA). Main PAD and AoD were measured on the same slice at level of pulmonary artery bifurcation, as reported by others [22] and in our previous pilot study [19]. PAD/AoD was then calculated.…”

“…A previous pilot study of our group on 161 consecutive patients undergoing pneumonectomy showed that normalized pulmonary artery diameter (NPAD) for body surface area (BSA) could be a predictor of postoperative respiratory failure and ARDS [19]. Thus, we aimed at reporting our more mature experience on the topic evaluating, in a larger series of pneumonectomy patients, the impact of several pre-operative parameters, including NPAD and pulmonary artery diameter (PAD)/aorta diameter (AoD) ratio, on the occurrence of post-pneumonectomy respiratory failure and ARDS.…”

Measuring Surgery Outcomes of Lung Cancer Patients with Concomitant Pulmonary Fibrosis: A Review of the Literature

“…Acute exacerbation of idiopathic pulmonary fibrosis (AEIPF) is characterized by diffuse and rapid alveolar damage on a background of IPF, which most likely occurs as a result of a massive lung injury from an unknown etiologic agent. Acute respiratory distress syndrome (ARDS) can also occur after surgery for lung cancer, with especially high incidence and mortality rates after pneumonectomy [ 19 , 20 , 21 ]. Thus, postoperative AE of IP can be a condition in which ARDS has occurred in a patient with IP-associated lung cancer who has undergone surgery.…”