scholarly journals Impact of pulmonary function on pulmonary complications after robotic-assisted thoracoscopic lobectomy

2019 ◽  
Vol 57 (2) ◽  
pp. 338-342
Author(s):  
Christopher Cao ◽  
Brian E Louie ◽  
Franca Melfi ◽  
Giulia Veronesi ◽  
Rene Razzak ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Eastern Cooperative Oncology Group ◽  
Multivariable Analysis ◽  
Primary Lung Cancer ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Postoperative Pulmonary Complications ◽  
Univariable Analysis ◽  
Predictive Values ◽  
Group Grade

Abstract OBJECTIVES Percentage-predicted forced expiratory volume in 1 s (FEV1) and diffusing capacity for carbon monoxide (DLCO), and their predicted postoperative (ppo) values are established prognostic factors for postoperative pulmonary complications after thoracotomy. However, their predictive value for minimally invasive pulmonary resections remains controversial. This study assessed the incidence of pulmonary complications after robotic lobectomy for primary lung cancer and analysed the predictive significance of FEV1 and DLCO. METHODS This was a retrospective analysis of patients who underwent robotic lobectomy from 4 institutions. Descriptive and comparative analyses were performed for patients who experienced pulmonary complications versus patients who did not, in relation to FEV1 and DLCO values. To identify thresholds for increased complications, patients were categorized into groups of 10% incremental increases in FEV1 and DLCO, and their ppo values. RESULTS From November 2002 to April 2018, 1088 patients underwent robotic lobectomy. Overall, 169 postoperative pulmonary complications occurred in 141 patients. Male gender and Eastern Cooperative Oncology Group grade ≥1 were associated with increased pulmonary complications on univariable analysis. Patients who experienced pulmonary complications had increased mortality (2.1% vs 0.2%, P = 0.017) and longer hospitalizations (9 vs 4 days, P < 0.001). Pulmonary complications were associated when FEV1 ≤60% and DLCO ≤50%, and when ppo FEV1 or DLCO was ≤50%; ppo FEV1 ≤50% (P < 0.001) and ppo DLCO ≤50% (P = 0.031) remained statistically significant on multivariable analysis. CONCLUSIONS Both FEV1 and DLCO were shown to be significant predictors of pulmonary complications. Furthermore, thresholds of percentage-predicted and ppo FEV1 and DLCO values were identified, below which pulmonary complications occurred significantly more frequently, suggesting their predictive values are particularly useful in patients with poorer pulmonary function.

Assessment of factors affecting short-term pulmonary functions following cardiac surgery: A prospective observational study

2021 ◽  
pp. 021849232110100
Author(s):  
Neetika Katiyar ◽  
Sandeep Negi ◽  
Sunder Lal Negi ◽  
Goverdhan Dutt Puri ◽  
Shyam Kumar Singh Thingnam
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Operative Morbidity ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Significant Impairment

Background Pulmonary complications after cardiac surgery are very common and lead to an increased incidence of post-operative morbidity and mortality. Several factors, either modifiable or non-modifiable, may contribute to the associated unfavorable consequences related to pulmonary function. This study was aimed to investigate the degree of alteration and factors influencing pulmonary function (forced expiratory volume in one second (FEV1) and forced vital capacity), on third, fifth, and seventh post-operative days following cardiac surgery. Methods This study was executed in 71 patients who underwent on-pump cardiac surgery. Pulmonary function was assessed before surgery and on the third, fifth, and seventh post-operative days. Data including surgical details, information about risk factors, and assessment of pulmonary function were obtained. Results The FEV1 and forced vital capacity were significantly impaired on post-operative days 3, 5, and 7 compared to pre-operative values. The reduction in FEV1 was 41%, 29%, and 16% and in forced vital capacity was 42%, 29%, and 19% consecutively on post-operative days 3, 5, and 7. Multivariate analysis was done to detect the factors influencing post-operative FEV1 and forced vital capacity. Discussion This study observed a significant impairment in FEV1 and forced vital capacity, which did not completely recover by the seventh post-operative day. Different factors affecting post-operative FEV1 and forced vital capacity were pre-operative FEV1, age ≥60, less body surface area, lower pre-operative chest expansion at the axillary level, and having more duration of cardiopulmonary bypass during surgery. Presence of these factors enhances the chance of developing post-operative pulmonary complications.

scholarly journals Importance of Pre Operative Pulmonary Function Test to Predict Risk of Pulmonary Complications after Abdominal Surgery- An Evidence Based Study

2021 ◽  
Vol 6 (3) ◽  
pp. 236-243
Author(s):  
Krupa Pareshbhai Patel ◽  
Anjali Bhise
Keyword(s):  
Abdominal Surgery ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Evidence Based ◽  
Function Tests ◽  
Function Test

Background: Spirometry is a universal, simple, and non-invasive pulmonary function test. Spirometry, along with calculation of the forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), is helpful for diagnosing obstructive or restrictive lung disease. Postoperative Pulmonary Complications are defined as unintended pulmonary abnormalities that occur as a result of surgery which cause identifiable dysfunction. Purpose: To find the evidence showing the importance of pre-operative PFT to predict risk of pulmonary complications after abdominal surgery Methodology: The study was conducted according to Preferred Reporting Items for systematic reviews and meta-analysis guidelines. Evidences selected since year 2002- 2020 from PubMed, Google Scholar, Physiotherapy Evidence Database (PEDro), ResearchGate and ScienceDirect. Key words used were: Pulmonary Function Tests, Post-Operative Pulmonary Complications, and Abdominal Surgery. Analysis was done using 2 scales: Centre for Evidence-Based Medicine Levels of Evidence Scale. Total 12 articles were found. Among them 10 were selected. Results: 5 articles showed that preoperative PFT is important in prediction of PPCs while the other half concluded that routine preoperative spirometry is not necessary before non-thoracic surgeries. Conclusion: Based on evidences, in the nutshell it is reviewed that there is controversy regarding the value of preoperative pulmonary functions test in non-thoracic surgeries. Keywords: Pulmonary Function Tests, Post-Operative Pulmonary Complications, and Abdominal Surgery

scholarly journals Increased Levels of Soluble CD206 Associated with Rapidly Progressive Interstitial Lung Disease in Patients with Dermatomyositis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Ya-Wen Shen ◽  
Ya-Mei Zhang ◽  
Zhen-Guo Huang ◽  
Guo-Chun Wang ◽  
Qing-Lin Peng
Keyword(s):  
Interstitial Lung Disease ◽  
Pulmonary Function ◽  
Lung Disease ◽  
Pulmonary Function Test ◽  
Multivariable Analysis ◽  
Forced Expiratory Volume ◽  
Enzyme Linked Immunosorbent Assay ◽  
Physician Global Assessment ◽  
Potential Biomarker ◽  
Function Test

Objective. Soluble CD206 (sCD206) is considered a macrophage activation marker, and a previous study proved it as a potential biomarker to predict the severity of anti-melanoma differentiation-associated gene 5- (anti-MDA-5-) positive dermatomyositis- (DM-) associated interstitial lung disease (ILD). To investigate the role of sCD206 in various subtypes of DM, we evaluated the serum level of sCD206 in patients with different myositis-specific autoantibodies besides anti-MDA-5 and clarified its clinical significance. Methods. Commercial enzyme-linked immunosorbent assay kits were used to detect serum concentrations of sCD206 in 150 patients with DM and 52 healthy controls (HCs). Correlations between sCD206 levels and clinical features, laboratory examinations, and pulmonary function test parameters were analysed. Results. The median concentrations of serum sCD206 in DM patients were significantly higher than those in HCs ( p < 0.0001 ). Furthermore, median sCD206 levels were elevated in patients with ILD ( p = 0.001 ), especially in those with rapidly progressive ILD (RP-ILD) ( p < 0.0001 ). In addition, sCD206 levels were negatively correlated with the pulmonary function test results, including the percent predicted forced vital capacity ( r = − 0.234 , p = 0.023 ), percent predicted forced expiratory volume in one second ( r = − 0.225 , p = 0.030 ), and percent predicted carbon monoxide diffusion capacity ( r = − 0.261 , p = 0.014 ). Age- and gender-adjusted multivariable analysis showed that sCD206 was an independent prognostic factor for RP-ILD in patients with DM. A longitudinal study showed that sCD206 levels were positively correlated with the physician global assessment visual analog scale scores ( β = 54.201 , p = 0.001 ). Conclusion. Serum sCD206 levels were significantly increased in patients with DM and significantly associated with RP-ILD, suggesting that sCD206 is an important biological predictor of RP-ILD in patients with DM.

scholarly journals An Evaluation of Preoperative Methods of Preventing Postoperative Pulmonary Complications

1977 ◽  
Vol 5 (1) ◽  
pp. 56-59 ◽  
Author(s):  
I. C. Wheatley ◽  
K. J. Hardy ◽  
C. E. Barter
Keyword(s):  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Respiratory Care ◽  
Postoperative Pulmonary Complications ◽  
X Ray ◽  
Function Test ◽  
Postoperative Respiratory Complications ◽  
Chest X Ray ◽  
Intensive Physiotherapy

The effectiveness of three current regimes of preoperative respiratory care in reducing postoperative respiratory complications following herniorrhaphy was studied prospectively. No smoking for five days plus intensive physiotherapy, five days no smoking, and routine hospital admission two days preoperatively were the regimes. Clinical, bacteriological, chest X-ray, blood gas and respiratory function test data were the criteria for assessment. The same surgical and anaesthetic team performed each operation. No statistical difference between the groups for pulmonary complications was noted. A significant correlation was found between the preoperative vital capacity and arterial pO2; also between the preoperative forced expiratory volume in one second-vital capacity ratio with the postoperative arterial pO2.

Postoperative atelectasis and pneumonia: risk factors

1995 ◽  
Vol 4 (5) ◽  
pp. 340-349 ◽  
Author(s):  
JA Brooks-Brunn
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Pulmonary Function ◽  
Infectious Complications ◽  
Hospital Length ◽  
Pulmonary Complications ◽  
Hospital Length Of Stay ◽  
Postoperative Pulmonary Complications ◽  
Patients At Risk ◽  
Factor Evaluation

Postoperative pulmonary complications frequently lead to increased patient morbidity and mortality, hospital length of stay, and resource utilization. Atelectasis and infectious complications account for the majority of reported pulmonary complications. Risk factors are thought to exaggerate pulmonary function deterioration, which occurs both during and after surgical procedures. This article reviews the literature and describes risk factors frequently identified in relation to pre-, intra-, and postoperative settings, impact of each risk factor on pulmonary function, and issues related to risk factor evaluation. Eighteen risk factors are reviewed regarding their pathophysiologic impact on pre-, intra-, and postoperative pulmonary function. Key issues related to risk factor evaluation are also discussed. Identification of risk factors and prediction of postoperative pulmonary complications are important. Early identification of patients at risk for postoperative pulmonary complications can guide our respiratory care to prevent or minimize these complications.

RA02.09: THE EFFECT OF PREOPERATIVE BREATHING EXERCISE IN PATIENTS UNDERGOING ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 22-22
Author(s):  
Hamakawa Takuya ◽  
Motohiro Hirao ◽  
Kazuhiro Nishikawa ◽  
Ayako Fujiwara ◽  
Sakae Maeda ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Respiratory Function ◽  
Vital Capacity ◽  
Conflicts Of Interest ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Transhiatal Esophagectomy ◽  
Postoperative Pulmonary Complications ◽  
Breathing Exercise ◽  
Subtotal Esophagectomy

Abstract Background Patients with esophageal cancer often have impaired respiratory function. Postoperative pulmonary complications frequently occur in patients undergoing esophagectomy. We instructed patients undergoing esophagectomy to do breathing exercise with Incentive Spirometer Coach 2 (Smiths medical) for at least two weeks before surgery, as well as smoking cessation. Methods We retrospectively reviewed medical records of 52 esophageal cancer patients who underwent spirometry both pre- and post- Coach 2 exercise between 2009 and 2017. We evaluated the change of respiratory function and postoperative complications. The influence of exercise was analyzed between patients who underwent neoadjuvant chemotherapy (NAC group, n = 36) and those treated without NAC (non-NAC group, n = 16). Results 39 males and 13 females were included. Median age was 65 (45–82). Surgical procedures were 48 subtotal esophagectomy, 3 transhiatal esophagectomy, and 1 pharyngo-laryngo-esophagectomy. Vital capacity (VC) and forced expiratory volume in one second (FEV1.0) were significantly improved through exercise; 3405 to 3600ml (P = 0.021) and 2485 to 2555 ml (P = 0.008), respectively. NAC group included more advanced-staged cases but age and baseline respiratory function were not significantly different from non-NAC group. Interval between first and second spirometry was 31 days for non-NAC group, 69 days for NAC group. After exercise, non-NAC group showed significant improvement in VC (3135 to 3600ml, P = 0.006), FEV1.0 (2255 to 2565ml, P = 0.004), whereas NAC group showed little change in VC (3560 to 3630ml, P = 0.514), FEV1.0 (2585 to 2555ml, P = 0.514). Postoperative complication occurred in 27 of 52 cases. Postoperative pneumonia occurred in 7 (13.5%) in the present cohort, which was less frequent than 42% in the historical control cohort without breathing exercise. Conclusion Preoperative breathing exercise with Coach 2 improved respiratory function in patients without NAC. In patients with NAC, the effect of exercise was smaller than non-NAC group, still exercise might suppress the decrease of respiratory function during NAC. Breathing exercise may reduce postoperative pulmonary complications. Disclosure All authors have declared no conflicts of interest.

scholarly journals The Predictive Value of Infant-Specific Preoperative Pulmonary Function Tests in Postoperative Pulmonary Complications in Infants with Congenital Heart Diseases

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Xin Liu ◽  
Feng Qi ◽  
Jichang Chen ◽  
Songrong Yi ◽  
Yanling Liao ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Respiratory Rate ◽  
Cardiac Catheterization ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Pulmonary Function Tests ◽  
Lung Compliance ◽  
Pulmonary Complications ◽  
Congenital Heart Diseases ◽  
Postoperative Pulmonary Complications

Background and Objective. To investigate the relationship between infant-specific preoperative pulmonary function tests (PFTs) and postoperative pulmonary complications (PPCs) in infants with congenital heart diseases (CHDs). Methods. Patients of 1-3 years of age who received surgical treatment for CHDs from January 1st, 2009, to December 31st, 2017, were retrieved. Records of preoperative PFTs, methods of operation, anesthesia procedures, intraoperative vital signs, respiratory support modalities, and PPCs was retrieved and analyzed. Results. 122 infants met the preset inclusion criteria, including 72 males and 50 females. There were 76 cases of thoracotomy and 46 cases of cardiac catheterization. The overall incidence of PPCs was 15.6%, including 19.7% after thoracotomy and 8.7% after cardiac catheterization, respectively (p>0.05). The incidence of PPCs was 35.4% or 2.7% in infants with a rapid or a normal respiratory rate, respectively; 42.1% or 3.6% in infants with an abnormal or a normal time to reach peak tidal expiratory flow versus the total expiratory time (TPTEF/TE), respectively; 39.0% or 3.7% in infants with an abnormal or a normal volume to peak expiratory flow versus the total expiratory volume (VPEF/VE), respectively; and 46.9% or 4.4% in infants with a decreased or a normal lung compliance, respectively (p<0.01 in all comparisons). Conclusions. The preoperative abnormal changes in respiratory rate, TPTEF/TE, VPEF/VE, and lung compliance are indicative of the risk of PPCs.

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