Preoperative Evaluation of Patients Undergoing Lung Resection Surgerya

Datta, Debapriya; Lahiri, Bimalin

doi:10.1378/chest.123.6.2096

Cited by 187 publications

(123 citation statements)

References 38 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…Until a couple of decades ago standard spirometric variables were considered crucial; particularly, increased postoperative morbidity and mortality were predicted by a FEV 1 <2 L/sec or 60% predicted for pneumonectomy, <1.6 L/sec for lobectomy and 0.6 L/sec for wedge resections and segmentectomy (60). More recently, the most commonly used functional algorithms for preoperative assessment suggest to consider the predicted post-operative (ppo) FEV 1 in choosing further tests or even excluding patients from operation without further tests (61).…”

Section: Assessment Of Elderly Patients Before Surgerymentioning

confidence: 99%

Lung cancer in elderly patients

et al. 2016

View full text Add to dashboard Cite

Section: Assessment Of Elderly Patients Before Surgerymentioning

confidence: 99%

Lung cancer in elderly patients

et al. 2016

View full text Add to dashboard Cite

“…Extensive lung function assessment for patients with a higher risk of major lung resection is recommended by guidelines [4,17] and decreases postoperative morbidity and mortality [24]. Poor pulmonary function parametersare strongly correlated with increased postoperative morbidity and mortality [1,[25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…Particularly the group with reduced lung capacity bordering on inoperability was the target group of our investigation. No single parameter for operative risk prediction exists, but there are several recommendations [4,25,34]. Severe reduction of FEV 1 was the main inclusion criterion for our study.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, pneumonia and acute respiretory failure are the main causes of postoperative death in about 46% of patients [2]. Especially in patients with reduced forced expiratory volume at one second (FEV 1 ) and diffusing lung capacity for carbon monoxide (DL-CO), postoperative mortality and morbidity increases inversely proportional to lung function [3][4][5][6][7]. Non-invasive pressure support ventilation (NIPSV) is a mode of mechanical ventilation without endotracheal intubation [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Non-Invasive Pressure Support Ventilation in Major Lung Resection for High Risk Patients: Does It Matter?

Danner

Koerber²,

Emmert³

et al. 2012

OJTS

View full text Add to dashboard Cite

Background and purpose: Patients with severely impaired pulmonary function have an increased operative risk for major lung resection. The clinical benefits of pre-and perioperative, non-invasive pressure support ventilation (NIPSV) have up to now not been extensively evaluated. Patients with severely reduced pulmonary function were investigated in this prospective and randomised single centre clinical trial. Methods: Standard pulmonary evaluation was performed in all patients before major lung resection. To predict postoperative pulmonary function, a lung perfusion-ventilation scan was carried out. All patients enrolled in the study were instructed preoperatively on how to use a NIPSV respirator. After lung resection patients were randomised either for continuation of NIPSV or for standard treatment. Results: Of the 52 patients assessed, 21 patients met the inclusion criteria for the study protocol. Predicted mean postoperative FEV 1 was 1.10 L (range 0.92 -1.27 L). Lobectomy was performed in 14 patients, pneumonectomy in 6 patients and a segmentectomy in 1 patient. No inhospital deaths occurred. Pulmonary complications (reintubation, pneumonia) were more frequent in the NIPSV group than in the control group (3 patients versus 1 patient), without statistical significance (p = 0.31). Conclusions: We observed no mortality and a low morbidity in this high risk group. Postoperative continuation of NIPSV had no beneficial effect on the clinical outcome. Preoperative conditioning with NIPSV, however, seems to be a suitable tool for patients with severely impaired pulmonary function. This study may serve therefore as basis for further investigations for the potential clinical benefits of prophylactic NIPSV in major lung surgery.

show abstract

“…The evaluation of lung function status is one of the most important steps in estimating the risk of postoperative respiratory failure and outcome. Functional status is a reliable predictor of perioperative and long-term cardiac events, and patients with preoperative reduced functional status have a higher risk of developing complications, 12,13 whereas those with a good preoperative functional status are at lower risk. The majority of reports base the preoperative evaluation of respiratory function on spirometry parameters-in particular, forced expiratory volume in the first second (FEV 1 ) and carbon monoxide diffusing capacity (DLCO).…”

Section: The Pulmunologist's Perspectivementioning

confidence: 99%