Frequency and mortality of acute lung injury and acute respiratory distress syndrome after pulmonary resection for bronchogenic carcinoma

Ruffini, Enrico; Parola, Andrea; Papalia, Esther; Filosso, Pier Luigi; Mancuso, Maurizio; Oliaro, A; Dato, Guglielmo Mario Actis; Maggi, G

doi:10.1016/s1010-7940(01)00760-6

Cited by 104 publications

(75 citation statements)

References 23 publications

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“…Kutlu et al (1) investigated the frequency and mortality of acute lung injury and acute respiratory distress syndrome in patients after pulmonary resection, and reported that 45 (3.9%) of 1,139 resected cases had postoperative acute lung injury or acute respiratory distress syndrome, while 29 (64.4%) of these 45 patients died. Ruffini et al (2) reported that 27 (2.2%) of 1,221 cases had postoperative acute lung injury or acute respiratory distress syndrome, and that 14 (51.9%) of those 27 patients died. Muraoka et al (7) reported that 9 (56.3%) of 16 patients died due to respiratory failure.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative interstitial pneumonia is a life-threatening complication with a high rate of mortality following surgery (1)(2)(3). Since it is difficult for patients with interstitial lung disease to undergo chemotherapy, radiation therapy or both, for their lung cancers, due to a high rate of exacerbation of interstitial pneumonia after treatment, surgical resection is sometimes the sole method of treatment for these patients.…”

Section: Introductionmentioning

confidence: 99%

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Prediction of postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease

Iyoda¹,

Jiang²,

Aoki³

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. Postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease has emerged as a serious problem. Therefore, the risk factors for postoperative exacerbation of interstitial pneumonia in patients with interstitial lung disease must be identified. We analyzed 22 patients diagnosed as having lung cancer with interstitial lung disease who underwent surgical treatment at the Kitasato University Hospital. Among the patients with lung cancer and interstitial lung disease, 5 patients (22.7%) had postoperative exacerbation of interstitial pneumonia. The prognosis of the patients with postoperative exacerbation was significantly poorer than that of patients without. Patients with postoperative exacerbation had a significantly higher age (≥75 years) and a significantly lower frequency of postoperative administration of steroid than patients without postoperative exacerbation. Almost all patients with postoperative exacerbation underwent lobectomy, had elevated KL-6 levels in the serum pre-operatively, and had significantly advanced stages of disease. Of the 5 patients with postoperative exacerbation, 2 had a history of inflammation prior to their exacerbation: 1 had a common cold and the other pyothorax. In patients with lung cancer and interstitial lung disease, advanced age, advanced stage disease, no postoperative administration of steroid and a pre-operative episode of inflammation are all risk factors for postoperative exacerbation of interstitial pneumonia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prediction of postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease

Iyoda¹,

Jiang²,

Aoki³

et al. 2011

Experimental and Therapeutic Medicine

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“…While the incidence of lung injury after lung resection is fairly consistent, between 2 and 4 % [10][11][12], the mortality rate has decreased from almost 100 % to less than 40 %, largely due to improvements in ICU management [1].…”

Section: Epidemiology and Impact Of Ards After Lung Resection Surgerymentioning

confidence: 99%

Volume Management and Resuscitation in Thoracic Surgery

Ashes

Slinger

2014

Curr Anesthesiol Rep

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Lung injury following thoracic surgery is a major cause of morbidity and mortality. A consistent risk factor is excessive perioperative fluid administration, not only following pneumonectomy, but also after lesser lung resections and esophageal surgery. Recent insights into the pathophysiology of lung injury after thoracic surgery include the role of the endothelial glycocalyx, pulmonary endothelium, lung lymphatics, and right ventricular dysfunction. While a restrictive approach to fluid administration may reduce the risk of lung injury, there are concerns regarding the risks of acute kidney injury with this approach. Goal-directed approaches may be applied to the thoracic surgical population, and lung ultrasound appears to be a promising new technique to further guide perioperative fluid therapy. There is a paucity of data to guide the choice of crystalloid or colloid solution. Further research is required regarding prevention, diagnosis, and treatment of lung injury following thoracic surgery.

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“…The postoperative 30-day mortality rate for lung cancer patients is reportedly 0.4 -0.6% in Japan (Watanabe et al 2004;Sakata et al 2010), but lung resection occasionally leads to postoperative acute lung injury or acute respiratory distress syndrome (ALI/ARDS), including acute exacerbation of pulmonary fibrosis (Ruffini et al 2001;Dulu et al 2006;Alam et al 2007;Chida et al 2008;Tang et al 2008;Saito et al 2011). The American College of Chest Physicians (ACCP) evidence-based clinical practice guideline (Colice et al 2007) indicates the patients at increased risk for postoperative mortality or morbidity after lung cancer resection based on physiological evaluation.…”

mentioning

confidence: 99%

“…However, it does not identify a specific patient who is going to develop postoperative ALI/ARDS. Previous studies have suggested that age, extensive resection, poor respiratory function, excessive perioperative transfusion, and low predicted postoperative diffusion capacity are risk factors for postoperative ALI/ ARDS (Ruffini et al 2001;Dulu et al 2006;Alam et al 2007;Tang et al 2008). Recently, Japanese researchers reported that acute exacerbation of idiopathic pulmonary fibrosis, one of the postoperative ALI/ARDS, was associated with a preoperative subclinical fibrotic change (Chida et al 2008;Saito et al 2011).…”

mentioning

confidence: 99%

Serum Thrombomodulin as a Newly Identified Biomarker for Postoperative Lung Injury: A Prospective Observational Study

Maeda

Takahashi

Sato

2012

Tohoku J. Exp. Med.

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Postoperative lung injury after lung cancer resection is still a difficult problem to be solved. Thrombomodulin (TM) is a membrane-bound glycoprotein of endothelial cells, and its serum level is elevated in patients with acute lung injury or acute respiratory distress syndrome. In fact, TM is abundant in the pulmonary capillary vessels. Lung resection reduces the volume of pulmonary capillary vessels; however, the change in the serum levels of TM after lung resection remains to be investigated. We therefore analyzed the postoperative changes in the serum TM levels in 60 patients who underwent thoracotomy without lung resection (n = 3), partial resection of the lung (n = 15), or lobectomy (n = 42). Preoperative and postoperative day-1 laboratory data including the serum levels of TM and KL-6, a sialylated carbohydrate antigen (a biomarker for pulmonary fibrosis), and oxygenation index were collected. Unexpectedly, the postoperative serum levels of TM were lower than preoperative values in lobectomy group, whereas they remained unchanged after thoracotomy without lung resection and after partial resection of the lung. In addition, the serum TM level decreased proportional to the resected lung volume. Eight out of 42 patients with lobectomy presented high postoperative serum levels of TM, and 3 out of these 8 patients presented postoperative impaired oxygenation. Postoperative impaired oxygenation occurred only in patients with elevated TM levels; namely, an increase of serum TM is associated with impaired oxygenation after lung resection. In conclusion, serum TM is a possible biomarker for predicting the occurrence of postoperative lung injury.

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Frequency and mortality of acute lung injury and acute respiratory distress syndrome after pulmonary resection for bronchogenic carcinoma

Cited by 104 publications

References 23 publications

Prediction of postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease

Prediction of postoperative exacerbation of interstitial pneumonia in patients with lung cancer and interstitial lung disease

Volume Management and Resuscitation in Thoracic Surgery

Serum Thrombomodulin as a Newly Identified Biomarker for Postoperative Lung Injury: A Prospective Observational Study

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