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Impact of the crural diaphragm thickness on pulmonary function after lobectomy
- Source :
- Asian Cardiovascular and Thoracic Annals. 27:388-393
- Publication Year :
- 2019
- Publisher :
- SAGE Publications, 2019.
-
Abstract
- Objective The crural diaphragm is responsible for pulmonary ventilation in the early period after lobectomy. However, the role of its thickness in pulmonary ventilation remains unclear. We investigated the impact of crural diaphragm thickness on pulmonary oxygenation and gas exchange early after lobectomy. Methods We enrolled 32 patients with non-small-cell lung cancer who underwent video-assisted thoracoscopic lobectomy. Crural diaphragm thickness was defined as the average of the maximum thicknesses of the right and left crural diaphragm at the level of the median arcuate ligament on computed tomography. Pulmonary oxygenation and gas exchange were evaluated by the ratio of arterial oxygen tension/fraction of inspiratory oxygen and alveolar-arterial oxygen difference on the second postoperative day. Results Crural diaphragm thickness of 7.0 ± 1.7 mm was associated with vital capacity. After lobectomy, arterial oxygen tension/fraction of inspiratory oxygen decreased significantly and alveolar-arterial oxygen difference increased significantly. Five patients with oxygen saturation via pulse oximetry ≤92% had a lower arterial oxygen tension/fraction of inspiratory oxygen and higher alveolar-arterial oxygen difference than the others. Crural diaphragm thickness in these patients was less than in the others (5.5 ± 1.9 vs. 7.3 ± 1.5 mm, p = 0.033). In multivariate analysis, crural diaphragm thickness remained an independent factor affecting arterial oxygen tension/fraction of inspiratory oxygen and alveolar-arterial oxygen difference ( p = 0.044, p = 0.049). Crural diaphragm thickness was positively associated with arterial oxygen tension/fraction of inspiratory oxygen and negatively associated with alveolar-arterial oxygen difference. Conclusion Crural diaphragm thickness affects pulmonary ventilation early after lobectomy.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Lung Neoplasms
Time Factors
medicine.medical_treatment
Diaphragm
Vital Capacity
chemistry.chemical_element
Computed tomography
Oxygen
Pulmonary function testing
Pneumonectomy
Predictive Value of Tests
Carcinoma, Non-Small-Cell Lung
Internal medicine
medicine
Electronic Health Records
Humans
Lung
Aged
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
Pulmonary Gas Exchange
Thoracic Surgery, Video-Assisted
business.industry
Median arcuate ligament
Recovery of Function
General Medicine
Oxygenation
Middle Aged
Diaphragm (structural system)
Treatment Outcome
medicine.anatomical_structure
chemistry
Cardiothoracic surgery
Cardiology
Female
Surgery
Pulmonary Ventilation
Tomography, X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 18165370 and 02184923
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Asian Cardiovascular and Thoracic Annals
- Accession number :
- edsair.doi.dedup.....0e911922cb18407a445553f5884cc070