Satoru Okada1, Kazuhiro Ito1, Junichi Shimada1, Daishiro Kato1, Masanori Shimomura1, Hiroaki Tsunezuka1, Naoko Miyata1, Shunta Ishihara1, Tatsuo Furuya1, Masayoshi Inoue2. 1. Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. 2. Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. mainoue@koto.kpu-m.ac.jp.
Abstract
OBJECTIVE: The purpose of this study was to clarify the clinical efficacy of postoperative non-invasive positive pressure ventilation (PONIV) after pulmonary lobectomy in patients with lung cancer. METHODS: From August 2010 and July 2015, 143 patients with lung cancer who underwent pulmonary lobectomy were retrospectively reviewed. PONIV was used immediately after surgery until the morning of postoperative day (POD) 1. Arterial blood gas was analyzed before and just after surgery (POD0) and on POD1. Oxygenation ability was perioperatively assessed by PaO2/FiO2 ratio, alveolar-arterial oxygen difference (A-aDO2), and respiratory index (A-aDO2/PaO2). RESULTS: 112 patients received PONIV. From POD0 to POD1, the PaO2/FiO2 ratio significantly improved in all patients who received PONIV (333 ± 83 to 359 ± 47 mmHg, p = 0.004). Moreover, A-aDO2 and respiratory index significantly decreased following PONIV. PONIV significantly improved the PaO2/FiO2 ratio in patients with PaO2/FiO2 ratio of ≤ 300 on POD0, older age (≥ 70 years), higher body mass index (≥ 25 kg/m2), and longer one-lung ventilation time (≥ 180 min). There was no respiratory failure requiring mechanical ventilation and no mortality. CONCLUSIONS: PONIV effectively improved oxygenation in patients undergoing pulmonary lobectomy in patients with poor status, especially in patients with PaO2/FiO2 ratio of ≤ 300 on POD0. PONIV could be an option of perioperative management for major thoracic surgery.
OBJECTIVE: The purpose of this study was to clarify the clinical efficacy of postoperative non-invasive positive pressure ventilation (PONIV) after pulmonary lobectomy in patients with lung cancer. METHODS: From August 2010 and July 2015, 143 patients with lung cancer who underwent pulmonary lobectomy were retrospectively reviewed. PONIV was used immediately after surgery until the morning of postoperative day (POD) 1. Arterial blood gas was analyzed before and just after surgery (POD0) and on POD1. Oxygenation ability was perioperatively assessed by PaO2/FiO2 ratio, alveolar-arterial oxygen difference (A-aDO2), and respiratory index (A-aDO2/PaO2). RESULTS: 112 patients received PONIV. From POD0 to POD1, the PaO2/FiO2 ratio significantly improved in all patients who received PONIV (333 ± 83 to 359 ± 47 mmHg, p = 0.004). Moreover, A-aDO2 and respiratory index significantly decreased following PONIV. PONIV significantly improved the PaO2/FiO2 ratio in patients with PaO2/FiO2 ratio of ≤ 300 on POD0, older age (≥ 70 years), higher body mass index (≥ 25 kg/m2), and longer one-lung ventilation time (≥ 180 min). There was no respiratory failure requiring mechanical ventilation and no mortality. CONCLUSIONS:PONIV effectively improved oxygenation in patients undergoing pulmonary lobectomy in patients with poor status, especially in patients with PaO2/FiO2 ratio of ≤ 300 on POD0. PONIV could be an option of perioperative management for major thoracic surgery.
Entities:
Keywords:
Lung cancer; Non-invasive positive pressure ventilation; Oxygenation; Surgery
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