1994
DOI: 10.1016/s0022-5223(94)70235-7
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Right heart function and prediction of respiratory morbidity in patients undergoing pneumonectomy with moderately severe cardiopulmonary dysfunction

Abstract: Detailed hemodynamic monitoring was performed in 20 patients undergoing pneumonectomy with moderately severe chronic obstructive pulmonary disease. Flow-directed pulmonary artery catheters capable of determining thermal dilution right ventricular ejection fraction and other indexes of right ventricular performance were placed in each patient. The mean actual and percent values for forced expiratory volume in 1 second in this group were 1.8 ± 0.5 Land 66 % ± 18%, respectively. Pulmonary hypertension was present… Show more

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Cited by 63 publications
(33 citation statements)
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“…Probably the number of patients in our study is not large enough to draw statistically significant conclusions. However, this observation might be supported by the report of Lewis et al (14).…”
Section: Co( Limin)supporting
confidence: 66%
“…Probably the number of patients in our study is not large enough to draw statistically significant conclusions. However, this observation might be supported by the report of Lewis et al (14).…”
Section: Co( Limin)supporting
confidence: 66%
“…The attractive features of radionuclide lung scanning include its ready availability in general hospitals, negligible risk to patients, and a fairly high degree of accuracy in the prediction of postoperative pulmonary function [28]. Pulmonary hemodynamic measurements may be useful in selected patients; a right ventricular ejection fraction of at least 35%, a pulmonary vascular resistance of less than 200 dyne × sec × cm -5 , and a ratio of pulmonary vascular resistance to right ventricular ejection fraction of less than 5.0 should be 1 -Specificity associated with low postpneumonectomy morbidity and mortality [29]. Exercise testing stresses the entire cardiopulmonary and oxygen delivery systems and assesses the reserve that can be expected and may be needed after surgery [30].…”
Section: Discussionmentioning
confidence: 99%
“…PAP increased during OLV and remained higher than baseline until the end of the study. In a study by Lewis and coworkers, 16 including 20 patients with moderately severe chronic obstructive pulmonary disease undergoing pneumonectomy, only 10% had a normal PAP in the immediate postoperative period. Others also reported a marked increase in right ventricular afterload during OLV and after completion of resection.…”
Section: Pneumonectomy Patientsmentioning
confidence: 98%
“…Others also reported a marked increase in right ventricular afterload during OLV and after completion of resection. [16][17][18] Increased right ventricular (RV) afterload in this situation most likely results from increased pulmonary vascular constriction secondary to hypoxic vasoconstriction (HPV), pulmonary microvascular plugging and decreased pulmonary vascular compliance. 17 Plasma concentrations of potent vasoconstrictive substances (e.g.…”
Section: Pneumonectomy Patientsmentioning
confidence: 99%