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Intensive Care Medicine pp 473–482Cite as

Post-pneumonectomy Pulmonary Edema

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Abstract

The first successful pneumonectomy was performed as a two step procedure by Rudolf Nissen in 1930. Although lesser resections are now performed when possible, in certain cases of non-small cell lung cancer, pneumonectomy provides the only potentially curative option. However, it is a procedure associated with a high mortality (3.3–9.3 %) and morbidity (30.6–59 %) [1–5]. Post-pneumonectomy pulmonary edema is not an infrequent complication of pneumonectomy (incidence 4–7 %) [6] and one that is associated with a mortality of at least 50 % [7]. Post-pneumonectomy pulmonary edema is often called post-lung resection acute lung injury, firstly due to its pathophysiological and clinical similarities to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), and secondly because it occurs following lobectomy as well as pneumonectomy. This chapter outlines the diagnosis and prevalence of this condition and then discusses the potential etiological factors.

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References

  1. Alexiou C, Beggs D, Rogers ML, Beggs L, Asopa S, Salama FD (2001) Pneumonectomy for non-small cell lung cancer: predictors of operative mortality and survival. Eur J Cardiothorac Surg 20: 476–480

    Article  CAS  PubMed  Google Scholar 

  2. Algar FJ, Alvarez A, Salvatierra A, Baamonde C, Aranda JL, Lopez-Pujol FJ (2003) Predicting pulmonary complications after pneumonectomy for lung cancer. Eur J Cardiothorac Surg 23: 201–208

    Article  PubMed  Google Scholar 

  3. Bernard A, Deschamps C, Allen MS, et al (2001) Pneumonectomy for malignant disease: factors affecting early morbidity and mortality. J Thorac Cardiovasc Surg 121: 1076–1082

    Article  CAS  PubMed  Google Scholar 

  4. Dancewicz M, Kowalewski J, Peplinski J (2006) Factors associated with perioperative complications after pneumonectomy for primary carcinoma of the lung. Interact Cardiovasc Thorac Surg 5: 97–100

    Article  PubMed  Google Scholar 

  5. Licker M, Spiliopoulos A, Frey JG, et al (2002) Risk factors for early mortality and major complications following pneumonectomy for non-small cell carcinoma of the lung. Chest 121: 1890–1897

    Article  PubMed  Google Scholar 

  6. Jordan S, Mitchell JA, Quinlan GJ, Goldstraw P, Evans TW (2000) The pathogenesis of lung injury following pulmonary resection. Eur Respir J 15: 790–799

    Article  CAS  PubMed  Google Scholar 

  7. Dulu A, Pastores SM, Park B, Riedel E, Rusch V, Halpern NA (2006) Prevalence and mortality of acute lung injury and ARDS after lung resection. Chest 130: 73–78

    Article  PubMed  Google Scholar 

  8. Turnage WS, Lunn JJ (1993) Postpneumonectomy pulmonary edema._A retrospective analysis of associated variables. Chest 103: 1646–1650

    Article  CAS  PubMed  Google Scholar 

  9. Waller DA, Gebitekin C, Saunders NR, Walker DR (1993) Noncardiogenic pulmonary edema complicating lung resection. Ann Thorac Surg 55: 140–143

    Article  CAS  PubMed  Google Scholar 

  10. Bernard GR, Artigas A, Brigham KL, et al (1994) The American-European Consensus Conference on ARDS._Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 149: 818–824

    CAS  PubMed  Google Scholar 

  11. Hayes JP, Williams EA, Goldstraw P, Evans TW (1995) Lung injury in patients following thoracotomy. Thorax 50: 990–991

    Article  CAS  PubMed  Google Scholar 

  12. Alam N, Park BJ, Wilton A, et al (2007) Incidence and risk factors for lung injury after lung cancer resection. Ann Thorac Surg 84: 1085–1091

    Article  PubMed  Google Scholar 

  13. Licker M, de Perrot M, Spiliopoulos A, et al (2003) Risk factors for acute lung injury after thoracic surgery for lung cancer. Anesth Analg 97: 1558–1565

    Article  PubMed  Google Scholar 

  14. Mathru M, Blakeman B, Dries DJ, Kleinman B, Kumar P (1990) Permeability pulmonary edema following lung resection. Chest 98: 1216–1218

    Article  CAS  PubMed  Google Scholar 

  15. Tang SS, Redmond K, Griffiths M, Ladas G, Goldstraw P, Dusmet M (2008) The mortality from acute respiratory distress syndrome after pulmonary resection is reducing: a 10-year single institutional experience. Eur J Cardiothorac Surg 34: 898–902

    Article  PubMed  Google Scholar 

  16. Bellingan GJ (2002) The pulmonary physician in critical care * 6: The pathogenesis of ALI/ ARDS. Thorax 57: 540–546

    Article  CAS  PubMed  Google Scholar 

  17. Groeneveld AB (1997) Radionuclide assessment of pulmonary microvascular permeability. Eur J Nucl Med 24: 449–461

    CAS  PubMed  Google Scholar 

  18. Groeneveld AB (2002) Vascular pharmacology of acute lung injury and acute respiratory distress syndrome. Vascul Pharmacol 39: 247–256

    Article  CAS  PubMed  Google Scholar 

  19. Waller DA, Keavey P, Woodfine L, Dark JH (1996) Pulmonary endothelial permeability changes after major lung resection. Ann Thorac Surg 61: 1435–1440

    Article  CAS  PubMed  Google Scholar 

  20. Baudouin SV (2003) Lung injury after thoracotomy. Br J Anaesth 91: 132–142

    Article  CAS  PubMed  Google Scholar 

  21. Cerfolio RJ, Bryant AS, Thurber JS, Bass CS, Lell WA, Bartolucci AA (2003) Intraoperative solumedrol helps prevent postpneumonectomy pulmonary edema. Ann Thorac Surg 76: 1029–1033

    Article  PubMed  Google Scholar 

  22. Park WY, Goodman RB, Steinberg KP, et al (2001) Cytokine balance in the lungs of patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 164: 1896–1903

    CAS  PubMed  Google Scholar 

  23. Schutte H, Lohmeyer J, Rosseau S, et al (1996) Bronchoalveolar and systemic cytokine profiles in patients with ARDS, severe pneumonia and cardiogenic pulmonary oedema. Eur Respir J 9: 1858–1867

    Article  CAS  PubMed  Google Scholar 

  24. Gebhard F, Marzinzig M, Hartel W, Bruckner UB (1997) [Systemic release of prostanoids after surgically-induced injury of lung tissue]. Langenbecks Arch Chir 382: 243–251

    CAS  PubMed  Google Scholar 

  25. Amat M, Barcons M, Mancebo J, et al (2000) Evolution of leukotriene B4, peptide leukotrienes, and interleukin-8 plasma concentrations in patients at risk of acute respiratory distress syndrome and with acute respiratory distress syndrome: mortality prognostic study. Crit Care Med 28: 57–62

    Article  CAS  PubMed  Google Scholar 

  26. Sampson SE, Costello JF, Sampson AP (1997) The effect of inhaled leukotriene B4 in normal and in asthmatic subjects. Am J Respir Crit Care Med 155: 1789–1792

    CAS  PubMed  Google Scholar 

  27. Thickett DR, Armstrong L, Christie SJ, Millar AB (2001) Vascular endothelial growth factor may contribute to increased vascular permeability in acute respiratory distress syndrome. Am J Respir Crit Care Med 164: 1601–1605

    CAS  PubMed  Google Scholar 

  28. Thickett DR, Armstrong L, Millar AB (2002) A role for vascular endothelial growth factor in acute and resolving lung injury. Am J Respir Crit Care Med 166: 1332–1337

    Article  PubMed  Google Scholar 

  29. Donnelly SC, Strieter RM, Kunkel SL, et al (1993) Interleukin-8 and development of adult respiratory distress syndrome in at-risk patient groups. Lancet 341: 643–647

    Article  CAS  PubMed  Google Scholar 

  30. Okusawa S, Gelfand JA, Ikejima T, Connolly RJ, Dinarello CA (1988) Interleukin 1 induces a shock-like state in rabbits. Synergism with tumor necrosis factor and the effect of cyclooxygenase inhibition. J Clin Invest 81: 1162–1172

    Article  CAS  PubMed  Google Scholar 

  31. Bhatia M, Moochhala S (2004) Role of inflammatory mediators in the pathophysiology of acute respiratory distress syndrome. J Pathol 202: 145–156

    Article  CAS  PubMed  Google Scholar 

  32. Zeldin RA, Normandin D, Landtwing D, Peters RM (1984) Postpneumonectomy pulmonary edema. J Thorac Cardiovasc Surg 87: 359–365

    CAS  PubMed  Google Scholar 

  33. van der Werff YD, van der Houwen HK, Heijmans PJ, et al (1997) Postpneumonectomy pulmonary edema._A retrospective analysis of incidence and possible risk factors. Chest 111: 1278–1284

    Article  PubMed  Google Scholar 

  34. Baker NH, Hill L, Ewy HG, Marable S (1967) Pulmonary lymphatic drainage. J Thorac Cardiovasc Surg 54: 695–696

    CAS  PubMed  Google Scholar 

  35. Nohl-Oser HC (1972) An investigation of the anatomy of the lymphatic drainage of the lungs as shown by the lymphatic spread of bronchial carcinoma. Ann R Coll Surg Engl 51: 157–176

    CAS  PubMed  Google Scholar 

  36. Lang JD, McArdle PJ, O’Reilly PJ, Matalon S (2002) Oxidant-antioxidant balance in acute lung injury. Chest 122:314S–320S

    Article  CAS  PubMed  Google Scholar 

  37. Zhang H, Slutsky AS, Vincent JL (2000) Oxygen free radicals in ARDS, septic shock and organ dysfunction. Intensive Care Med 26: 474–476

    Article  CAS  PubMed  Google Scholar 

  38. Metnitz PG, Bartens C, Fischer M, Fridrich P, Steltzer H, Druml W (1999) Antioxidant status in patients with acute respiratory distress syndrome. Intensive Care Med 25: 180–185

    Article  CAS  PubMed  Google Scholar 

  39. Williams EA, Quinlan GJ, Goldstraw P, Gothard JW, Evans TW (1998) Postoperative lung injury and oxidative damage in patients undergoing pulmonary resection. Eur Respir J 11: 1028–1034

    Article  CAS  PubMed  Google Scholar 

  40. de Perrot M, Liu M, Waddell TK, Keshavjee S (2003) Ischemia-reperfusion-induced lung injury. Am J Respir Crit Care Med 167: 490–511

    Article  PubMed  Google Scholar 

  41. Williams EA, Quinlan GJ, Anning PB, Goldstraw P, Evans TW (1999) Lung injury following pulmonary resection in the isolated, blood-perfused rat lung. Eur Respir J 14: 745–750

    Article  CAS  PubMed  Google Scholar 

  42. The Acute Respiratory Distress Syndrome Network._(2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342: 1301–1308

    Article  Google Scholar 

  43. Fernandez-Perez ER, Keegan MT, Brown DR, Hubmayr RD, Gajic O (2006) Intraoperative tidal volume as a risk factor for respiratory failure after pneumonectomy. Anesthesiology 105: 14–18

    Article  PubMed  Google Scholar 

  44. Ranieri VM, Suter PM, Tortorella C, et al (1999) Effect of mechanical ventilation on inflammatory mediators in patients with acute respiratory distress syndrome: a randomized controlled trial. JAMA 282: 54–61

    Article  CAS  PubMed  Google Scholar 

  45. Moss M, Parsons PE, Steinberg KP, et al (2003) Chronic alcohol abuse is associated with an increased incidence of acute respiratory distress syndrome and severity of multiple organ dysfunction in patients with septic shock. Crit Care Med 31: 869–877

    Article  PubMed  Google Scholar 

  46. Guidot DM, Roman J (2002) Chronic ethanol ingestion increases susceptibility to acute lung injury: role of oxidative stress and tissue remodeling. Chest 122:309S–314S

    Article  CAS  PubMed  Google Scholar 

  47. Amar D, Zhang H, Park B, Heerdt PM, Fleisher M, Thaler HT (2007) Inflammation and outcome after general thoracic surgery. Eur J Cardiothorac Surg 32: 431–434

    Article  PubMed  Google Scholar 

  48. Alho H, Sillanaukee P, Kalela A, Jaakkola O, Laine S, Nikkari ST (2004) Alcohol misuse increases serum antibodies to oxidized LDL and C-reactive protein. Alcohol Alcohol 39: 312–315

    CAS  PubMed  Google Scholar 

  49. Ramenofsky ML (1979) The effects of intrapleural pressure on respiratory insufficiency. J Pediatr Surg 14: 750–756

    Article  CAS  PubMed  Google Scholar 

  50. Alvarez JM, Panda RK, Newman MA, Slinger P, Deslauriers J, Ferguson M (2003) Postpneumonectomy pulmonary edema. J Cardiothorac Vasc Anesth 17: 388–395

    Article  PubMed  Google Scholar 

  51. Thomas P, Michelet P, Barlesi F, et al (2007) Impact of blood transfusions on outcome after pneumonectomy for thoracic malignancies. Eur Respir J 29: 565–570

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesia, Critical Care and Pain, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK

    D. Cook, E. Powell & F. Gao-Smith

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  1. D. Cook
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  2. E. Powell
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Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Universitée libre de Bruxelles, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Head) (Head)

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© 2009 Springer-Verlag Berlin Heidelberg

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Cook, D., Powell, E., Gao-Smith, F. (2009). Post-pneumonectomy Pulmonary Edema. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-92278-2_45

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  • DOI: https://doi.org/10.1007/978-0-387-92278-2_45

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-92277-5

  • Online ISBN: 978-0-387-92278-2

  • eBook Packages: MedicineMedicine (R0)

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