Pulmonary artery pressure and blood flow as predictors of outcome from lung cancer resection.
OBJECTIVE
Pulmonary hypertension is a putative risk factor for lung resection but catheter measurements are invasive. The aim of the present study was to assess prediction of mortality and complications from lung resection by Doppler echocardiographic estimates of pulmonary artery pressure (PAp) and soluble gas uptake estimates of effective pulmonary blood flow (Q(RB)).


METHODS
In 33 lung cancer patients, resting PAp (sys) and Q(RB) were measured preoperatively. In 13 patients, supine exercise estimates of PAp (sys) were also made and in five patients catheter PAp estimates were made.


RESULTS
Baseline PAp (sys) was 35 +/- 5 mmHg in four patients who died and 35 +/- 5 mmHg in 27 survivors. Post-exercise PAp (sys) was 58 +/- 11 mmHg in non-survivors and 60 +/- 11 mmHg in survivors (both not significant). Resting Q(RB) was 3.9 +/- 0.35 L/min in two non-survivors compared with 4.7 +/- 0.90 L/min in 22 survivors (P = 0.12) and was significantly lower in those experiencing complications. Regression analysis showed no significant relationship between resting or post-exercise PAp and mortality, although low Q(RB) tended towards predicting mortality (P = 0.07). There were also trends for higher PAp (sys) to predict respiratory and cardiac complications (P = 0.08) and for lower Q(RB) to predict unspecified or surgical complications.


CONCLUSIONS
PAp and Q(RB) did not predict outcome from lung resection better than baseline respiratory function indices.
Pierce
Robert J
RJ
Department of Respiratory, The University of Melbourne, Victoria, Australia. r.pierce@medicine.unimelb.edu.au
Sharpe
Ken
K
Johns
Jennifer
J
Thompson
Bruce
B
D000368:Aged; D001795:Blood Pressure Determination / Q000379:methods*; D006328:Cardiac Catheterization; D015150:Echocardiography, Doppler; D005080:Exercise Test; D006439:Hemodynamics; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011652:Pulmonary Circulation; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D011659:Pulmonary Gas Exchange; D012129:Respiratory Function Tests / Q000379:methods*; D018709:Statistics, Nonparametric