[Correlation between respiratory or circulatory state and postoperative extravascular lung water volume in patients undergoing surgery for esophageal carcinoma of the thorax].
Postoperative extravascular lung water index (EVLWI, ml/kg) was analyzed in 30 patients who underwent esophagectomy through right thoracotomy for esophageal carcinoma from the day of operation to 5th postoperative day, in order to clear the correlation between respiro-circulatory state and EVLWI. The results are as follows. 1. EVLWI on 1st postoperative day correlated significantly not only with blood loss during operation (p < 0.01, r = 0.65) but also with systemic vascular resistance index on 1st postoperative day (p < 0.05, r = -0.43). 2. EVLWI correlated with the respiratory index (RI) on the 2nd and 4th postoperative day (p < 0.01), suggesting that EVLWI is an important indicator in judging the respiratory state following esophagectomy. 3. EVLWI on 4th postoperative day correlated with accumulative fluid balance up to 4th postoperative day (p < 0.05, r = 0.41), however neither correlated with other hydrostatic parameters nor the COP-PCP gradient. Furthermore, EVLWI on 4th postoperative day correlated more significantly with oxygen consumption index (p < 0.05, r = 0.58) than that with accumulative fluid balance up to 4th postoperative day. According to those results, the increased systemic vascular permeability immediately after the surgery attributes to the increase of EVLWI on the 1st postoperative day. Whereas, the increased EVLWI on 4th postoperative day depends on not only the hydrostatical factors but also the increased pulmonary vascular permeability caused by the surgical maneuver to the lung during esophageal surgery.
Kusano
C
C
First Department of Surgery, Kagoshima University School of Medicine, Japan.
Baba
M
M
Sane
S
S
Kumanohoso
T
T
Shirao
K
K
Natsugoe
S
S
Fukumoto
T
T
Yoshinaka
H
H
Aikou
T
T
D004938:Esophageal Neoplasms / Q000503:physiopathology* / Q000601:surgery; D015633:Extravascular Lung Water / Q000378:metabolism*; D006439:Hemodynamics; D006801:Humans; D010101:Oxygen Consumption; D011184:Postoperative Period; D012119:Respiration; D013903:Thoracic Surgery; D014655:Vascular Resistance