Pre-and Postoperative Changes in Extravascular Lung Water in Patients with Lung Resection

ABSTRACT: The availability of measurement of extravascular lung water (EVLW) were clinically evaluated by using double indicator dilution technique and benefit from EVLW measurement was assessed in patients who underwent pulmonary resection. Thirty-one patients were divided into the three groups. Group I: comprise of five with partial resection or exploratory thoracotomy, Group II: 24 with lobectomy and Group III: two with pneumonectomy. 1) EVLE showed 6.0±2.9/kg six hours after surgery 6.8±3.3ml/kg on day 1, 6.6±3.0ml/ kg on day2, 6.5±2.8ml/kg on day 3 with significant decrease (p<0.05) as compared with preoperative one. 2) %EVLW, in which pulmonary vascular resistance was corrected, increased on day 1 with significant difference (p<0.05), indicating 100.7±3.75 at six hours, 118.1±48.4 % on day 1, 117±53.7 on day 2, 107.8±32.3 % on day 3. 3) %EVLW in group II was much higher than that in Group I on day 1 (p<0.05). 4) %EVLW in patients with massive blood transfusion over 800m1 showed significantly 5) %EVLW in patients with the operation time of more than four hours was higher than in those with less than four hours. In conclusion, EVLW tended to increase in case of prolonged operation time over four hours and large volume blood transfusion over 800ml when wide resection beyond lobectomy would be attempted. Surgeons should be aware of pre-pulmonary edema state in such a patient