The mortality from acute respiratory distress syndrome after pulmonary resection is reducing: a 10-year single institutional experience☆

Tang, Sarah; Redmond, Karen; Griffiths, Mark; Ladas, George; Goldstraw, Peter; Dusmet, Michael

doi:10.1016/j.ejcts.2008.06.020

Cited by 48 publications

(41 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Under mechanical ventilation, given the dishomogeneous distribution of lung injury, the regions that are relatively unaffected receive a disproportionate amount of the delivered tidal volume and are therefore at risk of overdistension (volutrauma). For this reason, to prevent further ventilator-induced lung damage, lung-protective ventilatory strategies, similar to those associated with the greater benefits in critically ill patients with ALI/ ARDS, should be implemented [80,81] Even though clear evidence on the best ventilatory technique in the specific setting of post-resectional ARDS is lacking, using low tidal volumes combined with lung recruitment maneuvers and moderate to high PEEP may ensure satisfactory gas exchange. The pressure-controlled mode of ventilation (vs. volume controlled mode) may also be useful to lower peak airway pressure and provide similar blood oxygenation indices [41].…”

Section: Post-resectional Ali/ards and Ventilatory Managementmentioning

confidence: 99%

Postoperative Care of Patients Undergoing Lung Resection

Serra¹,

Milevoj²

2013

J Anesthe Clinic Res

View full text Add to dashboard Cite

Section: Post-resectional Ali/ards and Ventilatory Managementmentioning

confidence: 99%

Postoperative Care of Patients Undergoing Lung Resection

Serra¹,

Milevoj²

2013

J Anesthe Clinic Res

View full text Add to dashboard Cite

“…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%

“…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%

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

Maeda

Takahashi

Sato

2012

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

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.

show abstract

“…1 The incidence of ARDS, the most severe form of lung injury, after lung resection is 2-5%, and post-pneumonectomy increases the occurrence up to 4 -15%. [1][2][3][4] Patients with ARDS require ventilatory assistance, usually escalating to endotracheal intubation and mechanical ventilation (ETMV), which is associated with increased mortality rate.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive Ventilation for Post-Pneumonectomy Severe Hypoxemia

Koutsogiannidis

Ampatzidou²,

Ananiadou

et al. 2012

Respir Care

View full text Add to dashboard Cite

ARDS remains a lethal complication after major lung resections. The reported mortality ranges from 50% to 100%, with increased incidence and mortality rates in pneumonectomy patients. The pathogenesis of early ARDS is still not fully understood, and the majority of patients will require mechanical ventilation. A review of the literature reveals that the role of noninvasive ventilation (NIV) in ARDS after lung resection is unclear, in contrast to its well established benefits in other types of respiratory failure. NIV is a technique of augmenting alveolar ventilation delivered by face mask, without introducing an endotracheal tube. NIV may reduce the need for endotracheal mechanical ventilation and improve clinical outcome in patients with acute respiratory failure after lung resection, avoiding complications related to intubation. We present a case of early ARDS following left-sided pneumonectomy, where bi-level positive airway pressure ventilation prompted a successful outcome.

show abstract

The mortality from acute respiratory distress syndrome after pulmonary resection is reducing: a 10-year single institutional experience☆

Abstract: The incidence and mortality of ARDS have decreased in our institution. We postulate that this is due to more aggressive strategies to avoid pneumonectomy, greater attention to protective ventilation strategies during surgery and to the improved ICU management of ARDS.

Cited by 48 publications

References 22 publications

Postoperative Care of Patients Undergoing Lung Resection

Postoperative Care of Patients Undergoing Lung Resection

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

Noninvasive Ventilation for Post-Pneumonectomy Severe Hypoxemia

Contact Info

Product

Resources

About