[The functionally amputated lung. Studies on the unilateral hyperlucent lung syndrome].
On the basis of comprehensive clinicopathological evidence 6 patients presenting with unilateral left-sided hyperlucent lungs are evaluated for pathogenesis, function and postoperative (n = 5) course. The common denominator in all proves to be moderate to severe hypoperfusion and overinflation of the respective lungs. Pulmonary function is characterized by a combined restrictive-obstructive pattern. In 4 patients overinflation is due to a central check-valve mechanism (tumor: n = 3; central airways collapse: n = 1), whereas in 2 increased translucency results from some sort of peripheral obstruction (Swyer-James syndrome: n = 1; congenital cystic bronchiectasis: n = 1). We consider the origin of hypoperfusion to be alveolar distension and hypoxic precapillary vasoconstriction, both participating in diminished blood flow to the check-valve obstructed lung. In Swyer-James syndrome reduced vascularity is an additional feature. Preoperative and long-term postoperative lung function data of 5 pneumonectomized patients are compared. On the whole, FEV1 and IVC remain unchanged, whereas the obstructive profile (RV, RV/TLC, sRAW) improves. From these data it is concluded that the affected hyperlucent lung is 'amputated' even before operation - irrespective of the nature of tissue damage. On the other hand postoperative relief of airways obstruction is supposed to be due to both antiobstructive medication and the removal of a diseased lung.
Wassermann
K
K
Abteilung für Lungen- und Bronchialheilkunde, Augusta-Kranken-Anstalten, Bochum, BRD.
Reitemeyer
E
E
Müller
K M
KM
Nakhosteen
J A
JA
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy; D011652:Pulmonary Circulation; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D011659:Pulmonary Gas Exchange; D011859:Radiography
Die funktionelle Pneumonektomie. Untersuchungen zum Problem der einseitig hellen Lunge.