Postresectional lung injury in thoracic surgery pre and intraoperative risk factors: a retrospective clinical study of a hundred forty-three cases.
BACKGROUND
Acute respiratory dysfunction syndrome (ARDS), defined as acute hypoxemia accompanied by radiographic pulmonary infiltrates without a clearly identifiable cause, is a major cause of morbidity and mortality after pulmonary resection. The aim of the study was to determine the pre and intraoperative factors associated with ARDS after pulmonary resection retrospectively.


METHODS
Patients undergoing elective pulmonary resection at Adnan Menderes University Medical Faculty Thoracic Surgery Department from January 2005 to February 2010 were included in this retrospective study. The authors collected data on demographics, relevant co-morbidities, the American Society of Anesthesiologists (ASA) Physical Status classification score, pulmonary function tests, type of operation, duration of surgery and intraoperative fluid administration (fluid therapy and blood products). The primary outcome measure was postoperative ARDS, defined as the need for continuation of mechanical ventilation for greater than 48-hours postoperatively or the need for reinstitution of mechanical ventilation after extubation. Statistical analysis was performed with Fisher exact test for categorical variables and logistic regression analysis for continuous variables.


RESULTS
Of one hundred forty-three pulmonary resection patients, 11 (7.5%) developed postoperative ARDS. Alcohol abuse (p = 0.01, OR = 39.6), ASA score (p = 0.001, OR: 1257.3), resection type (p = 0.032, OR = 28.6) and fresh frozen plasma (FFP)(p = 0.027, OR = 1.4) were the factors found to be statistically significant.


CONCLUSIONS
In the light of the current study, lung injury after lung resection has a high mortality. Preoperative and postoperative risk factor were significant predictors of postoperative lung injury.
Sen
Serdar
S
Department of Thoracic Surgery, Medical Faculty, Adnan Menderes University, Aydin, Turkey. drserdarsen@yahoo.com
Sen
Selda
S
Sentürk
Ekrem
E
Kuman
Nilgün Kanlıoğlu
NK
D000368:Aged; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D055370:Lung Injury / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011184:Postoperative Period; D057234:Preoperative Period; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors