Anesthetic considerations in 65 patients undergoing unilateral pneumonectomy: problems related to fluid therapy and hemodynamic control

Suehiro, Koichi; Okutani, Ryu; Ogawa, Satoshi

doi:10.1016/j.jclinane.2009.02.013

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…Pneumonectomy, according to Sueshiro et al, results in an abrupt decrease in the ventilation volume of the remaining lung as well as the pulmonary vascular bed after surgery, which causes right-sided heart failure due to acute pulmonary hypertension intraoperatively or postoperatively. Based on these results, the authors hypothesize that the development of postoperative heart failure is significantly correlated with fluid infusion volume, fluid balance volume, intraoperative total balance, blood loss volume, and blood transfusion [8].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Right Pneumonectomy with a Focus on the Right Ventricular Function and Hemodynamic Management

Logato¹,

Faria²,

Freitas³

et al. 2022

OJAnes

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Background: In patients undergoing pneumonectomy, intraoperative pulmonary and cardiac complications are the major cause of morbidity and mortality. Protective lung ventilation strategies may decrease the overall lung injury. Right, ventricular dysfunction may occur during the surgery and after the pneumonectomy, in the early postoperative period, with reduced RV ejection fraction and increased RV end-diastolic volume index, caused by increased RV afterload. Case report: We describe the case of a 28-year-old non-smoker female who underwent to a right pneumonectomy. The patient presented intraoperative hemodynamic instability and signs of RV dysfunction, requiring vasoactive amines and nitric oxide. Discussion: This article is intended to provide an overview of the anesthetic management for pneumonectomy including the hemodynamic management and considerations of the causes and management of right ventricular dysfunction.

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Section: Discussionmentioning

confidence: 99%

A Case Report of Right Pneumonectomy with a Focus on the Right Ventricular Function and Hemodynamic Management

Logato¹,

Faria²,

Freitas³

et al. 2022

OJAnes

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show abstract

“…Furthermore, Suehiro et al [10] found that high fluid infusion volumes during pneumonectomy were a risk factor for developing postoperative right-sided heart failure. However, even though fluid restriction seems to be an important factor in reducing complications after pneumonectomy, it may compromise cardiac output and ultimately lead to inadequate oxygen delivery.…”

Section: Discussionmentioning

confidence: 99%

Using clinical parameters to guide fluid therapy in high-risk thoracic surgery. A retrospective, observational study

et al. 2015

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BackgroundDespite extensive research, the debate continues as to the optimal way of guiding intraoperative and postoperative fluid therapy. In 2009 we changed our institutional guideline for perioperative fluid therapy in patients undergoing extrapleural pneumonectomy (EPP) and implemented the use of central venous oxygen saturation and intended low urine output to guide therapy in the early postoperative period. Here we evaluate the consequences of our changes.MethodsRetrospective, observational study of 30 consecutive patients undergoing EPP; 18 who had surgery before and 12 who had surgery after the changes. Data were collected from patient files and from institutional databases. Outcome measures included: Volumes of administered fluids, fluid balances, length of stays and postoperative complications. Dichotomous variables were compared with Fisher’s exact test, whereas continuous variables were compared with Student’s unpaired t-test or the Wilcoxon Two-Sample Test depending on the distribution of data.ResultsThe applied changes significantly reduced the volumes of administered fluids, both in the intraoperative (p = 0.01) and the postoperative period (p = 0.04), without increasing the incidence of postoperative complications. Mean length of stay in the intensive care unit (LOSI) was reduced from three to one day (p = 0.04) after the changes.ConclusionThe use of clinical parameters to balance fluid restriction and a sufficient circulation in patients undergoing EPP was associated with a reduction in mean LOSI without increasing the incidence of postoperative complications. Due to methodological limitations these results are only hypothesis generating.

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Intraoperative Factors and the Risk of Respiratory Complications After Pneumonectomy

Blank¹,

Hucklenbruch²,

Gurka³

et al. 2011

The Annals of Thoracic Surgery

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Anesthetic considerations in 65 patients undergoing unilateral pneumonectomy: problems related to fluid therapy and hemodynamic control

Cited by 7 publications

References 13 publications

A Case Report of Right Pneumonectomy with a Focus on the Right Ventricular Function and Hemodynamic Management

A Case Report of Right Pneumonectomy with a Focus on the Right Ventricular Function and Hemodynamic Management

Using clinical parameters to guide fluid therapy in high-risk thoracic surgery. A retrospective, observational study

Intraoperative Factors and the Risk of Respiratory Complications After Pneumonectomy

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