Abstract
A recent experimental study1 highlighted the perturbation in respiratory mechanics following lung resection, focusing on the decrease in lung compliance (CL) as a potential cause of air leak and lung edema. Based on lung-chest wall pleural mechanical coupling, we derived pre and post-operative values of static CL in human anesthetized patients (N=10) for the operated lung (minimally-invasive video-assisted surgery) and the contralateral one. Using a double-lumen bronchial intubation, the ratio of alveolar volume to alveolar pressure yielded CL for each lung; measurements were continued up to the extubation of the patient. Average CL of each lung pre-operation was 53±3(SE) ml/cmH2O; the weight of the resected portion was 166±33(SE) g amounting to about 36±2% of the weight of the operated lung. Figure shows that the average decrease in CL for the resected lung (closed circles) amounted to about 40%, and further decreased down to 50% of control value at time of extubation (P<0.001). Time from opening of the thorax to the completion of operation was variable depending upon surgery. In the intact lung (open circles) CL increased following lung resection, reflecting blood overperfusion, returning to normal at extubation time. We conclude that the potential detrimental effects of lobar resection on CL should be balanced using postoperative management strategies aimed at restoring the physiologic CL.
1Salito C et al. EJCTS2013
The study was funded in part by Medela AG.
- © 2014 ERS