Anesthetic considerations in 65 patients undergoing unilateral pneumonectomy: problems related to fluid therapy and hemodynamic control.
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.
Suehiro
Koichi
K
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>
Okutani
Ryu
R
Ogawa
Satoru
S
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
D002395:Catecholamines