Postpneumonectomy Pulmonary Edema
The operative mortality of elective pulmonary resection has steadily declined over the past several decades. Patient selection, preoperative preparation, anesthesia, operative techniques, and postoperative care have all improved. Despite these advances in thoracic surgical care one particular form of pulmonary resection (pneumonectomy) continues to have a relatively high operative mortality. In many centers 5–10% of patients die postoperatively. For most other major thoracic surgical procedures operative mortality can be reduced to approximately 1 or 2% by centralizing patients in high-volume centers, which are staffed with experienced surgeons. Eliminating postoperative death after pneumonectomy, however, is more difficult. Postpneumonectomy acute lung injury (postpneumonectomy pulmonary edema, PPE) remains difficult to prevent and treat; it is a major unsolved problem in the field of pulmonary resection. This chapter will review the definition, clinical presentation, etiology, pathogenesis, prevention and treatment of postpneumonectomy pulmonary edema.
KeywordsAcute Lung Injury Pulmonary Resection Mediastinal Lymph Node Dissection Lymphatic Obstruction Noncardiogenic Pulmonary Edema
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Deslauriers J, Aucoin A, Gregoire J. Early complications. Postpneumonectomy pulmonary edema. Chest Surg Clin N Am 1999;9:565–85.Google Scholar
Jordan S, Mitchell JA, Quinlan GJ, Goldstraw P, Evans TW. The pathogenesis of lung injury following pulmonary resection. Eur Respir J 2000;15:790–9.PubMedCrossRefGoogle Scholar
Kutlu CA, Williams EA, Evans TW, Pastorino U, Goldstraw P. Acute lung injury and acute respiratory distress syndrome after pulmonary resection. Ann Thorac Surg 2000;69:376–80.PubMedCrossRefGoogle Scholar
Parquin F, Marchal M, Mehiri S, Herve P, Lescot B. Post-pneumonectomy pulmonary edema: analysis and risk factors. Eur J Cardiothorac Surg 1996;10:929–33.PubMedCrossRefGoogle Scholar
Shapira OM, Shahian DM. Postpneumonectomy pulmonary edema. Ann Thorac Surg 1993;56:190–5.PubMedCrossRefGoogle Scholar
van der Werff YD, van der Houwen HK, Heijmans PJ, et al. Postpneumonectomy pulmonary edema. A retrospective analysis of incidence and possible risk factors. Chest 1997;111:1278–84.PubMedCrossRefGoogle Scholar
Waller DA, Gebitekin C, Saunders NR, Walker DR. Noncardiogenic pulmonary edema complicating lung resection. Ann Thorac Surg 1993;55:140–3.PubMedCrossRefGoogle Scholar
Waller DA, Keavey P, Woodfme L, Dark JH. Pulmonary endothelial permeability changes after major lung resection. Ann Thorac Surg 1996;61:1435–40.PubMedCrossRefGoogle Scholar
Zeldin RA, Normandin D, Landtwing D, Peters RM. Postpneumonectomy pulmonary edema. J Thorac Cardiovasc Surg 1984;87:359–65.PubMedGoogle Scholar
Zwischenberger JB, Alpard SK, Bidani A. Early complications. Respiratory failure. Chest Surg Clin N Am 1999;9:543–64.PubMedGoogle Scholar
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