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Evaluation of respiratory status in patients after thoracic esophagectomy using PiCCO system.
- Source :
-
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia [Ann Thorac Cardiovasc Surg] 2008 Oct; Vol. 14 (5), pp. 283-8. - Publication Year :
- 2008
-
Abstract
- Purpose: Thoracic esophagectomy for esophageal cancer is among the most invasive operations, requiring thoracotomy and laparotomy. With regard to postoperative status, the increment of vascular permeability caused by various inflammatory cytokines might influence the postoperative respiratory condition. The PiCCO (pulse contour cardiac output) system (Pulsion Medical Systems AG, Munich, Germany), a new technique based on an arterial thermodilution technique, allows the measurement of extravascular lung water (EVLW). In this study, we hypothesized that EVLW might be a useful parameter to assess the respiratory condition and evaluated respiratory status using values for EVLW after thoracic esophagectomy.<br />Patients and Methods: The PiCCO system was established in the intensive care unit (ICU) in 25 patients immediately after thoracic esophagectomy for esophageal cancer. EVLWI (EVLW/body weight, normal range: 3-7 ml/kg) was measured on ICU days (ICUD) 1, 2, and 3. The PaO(2)/FiO(2) (P/F ratio), pulmonary compliance, and lung injury score (LIS) were also calculated, and relationships between EVLWI and those parameters were evaluated.<br />Results: Mean operating time, blood volume, and fluid balance during surgery were 515+/- 16 (395-690) min, 721+/- 91 (167-1,770) ml, and 3,462+/- 292 (1,892-7,300) ml, respectively. The mean ICU stay was 3.4 +/- 0.3 (2-10) days, and all patients were discharged from the ICU without complications. EVLWI gradually increased after surgery with values of 8.6+/- 1.9 ml/kg on ICUD 1, 9.7+/- 2.7 ml/kg on ICUD 2, and 10.0+/- 3.0 ml/kg on ICUD 3. EVLWI was well correlated with P/F ratio (r = -0.358, p = 0.0135), pulmonary compliance (r = -0.625, p = 0.0001), and LIS (r = 0.614, p = 0.0001).<br />Conclusion: EVLWI may be a useful parameter for evaluation of the respiratory condition after thoracic esophagectomy.
- Subjects :
- Adult
Aged
Blood Volume
Critical Care
Female
Humans
Lung Compliance
Lung Injury metabolism
Lung Injury physiopathology
Male
Middle Aged
Postoperative Care
Time Factors
Treatment Outcome
Water-Electrolyte Balance
Cardiac Output
Esophageal Neoplasms surgery
Esophagectomy adverse effects
Extravascular Lung Water metabolism
Lung Injury diagnosis
Respiration
Thermodilution instrumentation
Thoracotomy adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 2186-1005
- Volume :
- 14
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
- Publication Type :
- Academic Journal
- Accession number :
- 18989243