title: Prophylactic respiratory management after liver resection with bilevel positive airway pressure ventilation: Report of three cases.
abstract: Pulmonary complications after hepatectomy occur with relative frequency and are associated with increased morbidity and mortality. Moreover, their prevention is often difficult. We report using prophylactic bilevel positive airway pressure ventilation, initiated just after the operation, for the successful postoperative respiratory management of three patients predisposed to the development of pulmonary complications. One patient had insufficient pulmonary function (forced expiratory volume in 1 s (FEV(1)) 0.95 l; FEV(1)/forced vital capacity 40.8%) caused by previous thoracoplasty. The other two patients were obese and had obstructive sleep apnea syndrome (OSAS). None of the patients required endotracheal intubation after hepatectomy, although the two with severe OSAS suffered pulmonary thromboembolism postoperatively. Bilevel positive airway pressure ventilation was well tolerated and there were no adverse effects, suggesting its effectiveness for preventing pulmonary complications after hepatectomy.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Syogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Narita
authors.forename: Etsuro
authors.initials: E
authors.lastname: Hatano
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Nagata
authors.forename: Atsuko
authors.initials: A
authors.lastname: Yanagida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Asechi
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Takahashi
authors.forename: Iwao
authors.initials: I
authors.lastname: Ikai
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*