Chest
Clinical Investigations: SurgeryPostpneumonectomy Pulmonary Edema: A Retrospective Analysis of Incidence and Possible Risk Factors
Section snippets
MATERIALS AND METHODS
Clinical data of 197 consecutive patients who underwent a pneumonectomy during the period from January 1989 through January 1995 were collected retrospectively. The aim was to determine the incidence and mortality of PPE, as well as to assess the potential preoperative, perioperative, and postoperative risk factors for the occurrence of PPE. Preoperative, perioperative, and postoperative clinical data were retrieved from medical records and evaluated. A list of the analyzed parameters is shown
RESULTS
Pulmonary edema was found in 54 of the 197 patients in the postoperative phase. Of these, 25 had pulmonary edema due to causes other than PPE. The pulmonary edema in 14 patients was due to heart failure. Five patients had manifestations of severe atelectasis. In four patients, the visible abnormalities were due to infectious lung disease. In one patient, the ARDS was due to pancreatitis, which complicated the postoperative recovery. In another patient, the edema and consolidation were due to
DISCUSSION
PPE is a serious complication. Characteristically, a pneumonectomy patient suffering from PPE complains of severe dyspnea in the first 3 postoperative days. The dyspnea is not relieved by supplemental oxygen. Chest radiography will usually show signs of pulmonary edema following the onset of symptoms. In the manifest form, the pulmonary congestion starts to consolidate despite reintubation, mechanical ventilation, and forced diuresis.
The vast majority die as a result of multiple organ failure.2
ACKNOWLEDGMENTS
We thank Linda C. Meiners and Margaret Bush Estabrook for valuable help.
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