Prevalence and mortality of acute lung injury and ARDS after lung resection Journal Article
| Authors: | Dulu, A.; Pastores, S. M.; Park, B.; Riedel, E.; Rusch, V.; Halpern, N. A. |
| Article Title: | Prevalence and mortality of acute lung injury and ARDS after lung resection |
| Abstract: | Study objectives: To describe the frequency and outcome of patients with acute lung injury (ALI) and AMDS who require mechanical ventilation (MV) after lung resection, and to analyze preoperative and perioperative variables associated with mortality. Methods: We retrospectively reviewed the case records of all patients who underwent lung resection and acquired ALI and/or ARDS and required invasive MV and ICU admission at a tertiary-care cancer center from January 1, 2002, to December 31, 2004. Preoperative and perioperative information including ICU-specific variables and outcome data were analyzed. Data are presented as median (range). Results: During the study period, 2,039 patients underwent a total of 2,192 lung resections. ALI/ARDS developed in 50 patients (2.45%). The prevalence of ALI/ARDS by procedure was as follows: pneumonectomy, 7.9% (10 cases in 126 procedures); lobectomy/bilobectomy, 2.96% (31 cases in 1,047 procedures); and sublobar resection, 0.88% (9 cases in 1,019 procedures). There were 28 men (56%) and 22 women (44%). Median age was 68.5 years (range, 44 to 88 days). Median time of presentation to the ICU with ALI/ARDS following surgery was 4 days (range, 1 to 22 days). Median ICU length of stay was 10 days (range, 2 to 43 days), and median hospital LOS was 26.5 days (range, 6 to 93 days). During hospitalization, 20 of the 50 patients (40%) died: 16 in the ICU and 4 after ICU discharge. The mortality rate was highest after pneumonectomy (50%), followed by lobectomy (42%) and sublobar resections (22%). Although increased age was associated with a higher ICU mortality, none of the preoperative and perioperative variables were significantly associated with hospital mortality. There was a marginally significant association between mortality and time of presentation to the ICU after surgery (p = 0.06). Conclusions: Our results confirm that ALI/ARDS after lung resection is associated with a high mortality, in patients who require invasive MV and ICU care. |
| Keywords: | adult; cancer chemotherapy; clinical article; aged; aged, 80 and over; middle aged; retrospective studies; mortality; review; gastrointestinal hemorrhage; cancer radiotherapy; preoperative evaluation; treatment indication; infection; kidney disease; lung lobectomy; lung resection; prevalence; lung cancer; smoking; bradycardia; retrospective study; postoperative complication; postoperative complications; intensive care unit; length of stay; lung metastasis; intensive care units; statistical analysis; death; cardiovascular disease; stroke; acute heart infarction; comorbidity; lung; sepsis; colitis; perioperative period; age distribution; lung surgery; forced expiratory volume; clostridium difficile; lung function test; gastrointestinal disease; heart atrium fibrillation; bronchopleural fistula; physiotherapy; heart ventricle tachycardia; artificial ventilation; icu; venous thromboembolism; adult respiratory distress syndrome; lung complication; thoracic surgery; bacterial pneumonia; mechanical ventilation; acute lung injury; respiratory distress syndrome, adult; respiration, artificial; acute cholecystitis; ards; ischemic colitis |
| Journal Title: | Chest |
| Volume: | 130 |
| Issue: | 1 |
| ISSN: | 0012-3692 |
| Publisher: | American College of Chest Physicians |
| Date Published: | 2006-07-01 |
| Start Page: | 73 |
| End Page: | 78 |
| Language: | English |
| DOI: | 10.1378/chest.130.1.73 |
| PUBMED: | 16840385 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 36" - "Export Date: 4 June 2012" - "CODEN: CHETB" - "Source: Scopus" |
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