Bullectomy is beneficial in the pulmonary blood flow/driving pressure relationship in bullous emphysema patients.
OBJECTIVE
Few physiological studies have been on pulmonary circulation, including the relationship between pulmonary blood flow and driving pressure, and viscosity changes arising from hematocrit changes before versus after lung volume reduction Surgery or bullectomy in emphysematous patients.


METHODS
We studied the relationship between pulmonary blood flow and driving pressure before and after bullectomy using a unilateral pulmonary artery occlusion test based on pulmonary blood flow fractions obtained by pulmonary blood flow scintigraphy in 7 patients with pulmonary emphysema associated with bullae.


RESULTS
Among the 7 undergoing bullectomy, the pulmonary blood flow/driving pressure relationship decreased in 5 and was unchanged in 2. Of the 11 lungs treated by bullectomy, this relationship decreased in 8 lungs, but not 3 (p < 0.01). No significant difference was seen in oxygen partial pressure in arterial and mixed venous blood or hematocrit.


CONCLUSIONS
We concluded that bullectomy shifted the pulmonary blood flow/driving pressure relationship downword in some cases with significant bullae.
Onuki
T
T
Department of Surgery I, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
Murasugi
M
M
Sone
Y
Y
Ikeda
T
T
Oyama
K
K
Nitta
S
S
D000368:Aged; D001768:Blister / Q000601:surgery; D001794:Blood Pressure; D002302:Cardiac Output; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011652:Pulmonary Circulation; D011656:Pulmonary Emphysema / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure