Management of Complications After Pneumonectomy

Groth, Shawn S.; Burt, Bryan M.; Sugarbaker, David J.

doi:10.1016/j.thorsurg.2015.04.006

Cited by 20 publications

(10 citation statements)

References 86 publications

(126 reference statements)

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“…The unilateral absence of the pulmonary artery increases the blood flow and pressure that is seen by the existent pulmonary artery increasing the chance of pulmonary hypertension develops 2 . In addition, pulmonary hypertension can also be seen in the postpneumonectomy setting in those who initially had both pulmonary arteries present due to a similar process involving increased blood flow and pressure seen as a consequence of arterial ligation 4 . The presence of peripheral pulmonary arteries as seen on pathology likely helped prevent the development of more severe cardiac complications in this patient.…”

Section: Discussionmentioning

confidence: 99%

A case of recurrent pneumothoraces in a newborn

George

Ortenberg

Pinto

2022

Pediatric Pulmonology

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Pneumothoraces are not an uncommon finding in the newborn period. Recurrent pneumothoraces can be associated with complications of prematurity or use of ventilators but can be seen in rapidly progressive cystic lung disease. We report a case of recurrent pneumothoraces in an infant with the rapidly progressive cystic disease in the setting of an absent right pulmonary artery. The patient ultimately underwent pneumonectomy for definitive management of the recurrent unilateral pneumothoraces.

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Section: Discussionmentioning

confidence: 99%

A case of recurrent pneumothoraces in a newborn

George

Ortenberg

Pinto

2022

Pediatric Pulmonology

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“…They occur in 1.7% to 11% of postpneumonectomy patients and mortality can be up to 40%. [46][47][48][49]74,75 BPFs share many of the same risk factors as postpneumonectomy empyemas, except that earlier fistulas (within 1 week of surgery) are often associated with technical failure to close the stump, or extensive dissection of the stump leading to devascularization.…”

Section: Bronchopleural Fistulamentioning

confidence: 99%

Pneumonectomy for Non–Small Cell Lung Cancer

Sugarbaker

Haywood-Watson

Wald

2016

Surgical Oncology Clinics of North America

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“…In the era of parenchymal-sparing procedures (bronchial and bronchovascular sleeves), minimally invasive techniques or radiotherapic treatments for advanced lung cancers, the rate of pneumonectomy was reduced; nevertheless, in some cases pneumonectomy rests the only therapeutic approach to keep oncological radicality. However, it is associated with the highest postoperative morbidity (1,2) and mortality rate, ranging from 5% to 9% (3,4) among pulmonary resections.…”

Section: Introductionmentioning

confidence: 99%

Postpneumonectomy respiratory failure and acute respiratory distress syndrome: risk factors and outcome

Mazzella¹,

Iacono²,

Alifano³

2021

Shanghai Chest

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Pneumonectomy is related with a high postoperative morbidity and mortality rate, ranging from 5% to 9%. Post-pneumonectomy respiratory failure (ARF) acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are grave and disastrous complications in these patients, necessitating invasive mechanical ventilation (IMV). In different series reported in literature, ARDS after lung resection occurred in 1-8% of patients and the mortality amounts in a range between 30% to 80%. We have reviewed the literature in order to clarify the different risk factors in the development of ARDS post pneumonectomy.According to different papers, the most important pre-operative risk factors are represented by age and sex, comorbidities (smoking, diabetes, COPD), pre-operative respiratory function and right side of pneumonectomy. Concerning peri and immediately post-operative management of these patients, the key role is represented by the IMV and the fluid infusion and cardiac preload during and after surgery.In summary, ALI and ARDS after pneumonectomy are closely linked to any direct or indirect pulmonary insult, responsible of endo-alveolar oedema. An inappropriate fluid infusion during or after surgery, may be exacerbate endo-alveolar oedema and encourage the development of ALI and ARDS. In this perspective, the best management of these patients should be achieved by a multidisciplinary team made by thoracic surgeons, respiratory physicians, anaesthesiologists, physiotherapists and nurses dedicated in ICUs.

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Management of Complications After Pneumonectomy

Cited by 20 publications

References 86 publications

A case of recurrent pneumothoraces in a newborn

A case of recurrent pneumothoraces in a newborn

Pneumonectomy for Non–Small Cell Lung Cancer

Postpneumonectomy respiratory failure and acute respiratory distress syndrome: risk factors and outcome

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