title: Anesthetic considerations in 65 patients undergoing unilateral pneumonectomy: problems related to fluid therapy and hemodynamic control.
abstract: OBJECTIVE
  To examine perioperative management and complications in patients undergoing pneumonectomy.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  University-affiliated city hospital.
  
  
  METHODS
  65 patients who underwent unilateral pneumonectomy for resection of lung cancer between March 1997 and October 2007 were included in this study. Patients who underwent pneumonectomy were then classified into two groups: Group C patients had signs of postoperative acute right heart failure, and Group N patients had no signs of postoperative acute right heart failure.
  
  
  RESULTS
  In the pneumonectomy patients, extubation did not occur in 8 patients (12%) and postoperative death occurred in 4 patients (6%), compared with no such occurrences among patients who underwent lobectomy. Perioperative respiratory function was significantly lower in Group C (P < 0.05) than Group N. Fluid infusion volume, fluid balance volume, intraoperative total fluid balance, urine output volume, blood loss volume, blood transfusion volume, times of administration of vasopressors intraoperatively, and number of patients requiring intraoperative administration of catecholamines were significantly greater in Group C (P < 0.05) than Group N.
  
  
  CONCLUSIONS
  Fluid infusion volume, fluid balance volume, intraoperative total balance, blood loss volume, and blood transfusion volume were important intraoperative risk factors in the development of postoperative right-sided heart failure.
authors.affiliation: Department of Anesthesiology and Pediatric Anesthesia, Osaka City General Hospital and Children's Hospital, Osaka City, 534-0021, Osaka, Japan. suehirokoichi@yahoo.co.jp <suehirokoichi@yahoo.co.jp>
authors.forename: Koichi
authors.initials: K
authors.lastname: Suehiro
authors.forename: Ryu
authors.initials: R
authors.lastname: Okutani
authors.forename: Satoru
authors.initials: S
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods*; D016063:Blood Loss, Surgical; D002395:Catecholamines / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects*; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012307:Risk Factors; D015996:Survival Rate; D065227:Transfusion Reaction; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines