Abstract
The purpose of the study. Show the possibility of additional evaluation of functional operability of patients with progressive pulmonary tuberculosis (PPT) at pneumonectomy using the transpulmonary thermodilution (TPT).
Material and methods . The study included 88 patients aged 38.8 ± 1.8 years in need of PE over PPT. Preoperative evaluation included spirometry, lung perfusion scintigraphy, the use of the TPT (series instruments PICCO, Pulsion MedSys, Germany) with an estimate of the absolute and indexed values of extravascular fluid in the lung (EVLW), blood gas (RaO2/FiO2 ) .
Results. PPT patients before surgery, depending on the volume of lung tissue destruction, determined a direct correlation between the decrease in VC and FEV1 (R = 0.78, p <0.0000001). EVLW content correlated with the values of VC (R = 0.53, p <0.0000001). It was calculated the ratio VC (ml) to EVLW (ml). Under normal' values , it is 10-24 1/1, with PPT it declined. It was found correlation between VC / EVLW and pulmonary vascular permeability index (R = - 0.36, p = 0.001), and between the index values and RaO2/FiO2 (R = 0.38, p = 0.0002). In response to a fluid therapy in patients with low values of VC / EVLW increase EVLW index (Δ EVLWI, ml / kg) was greater (R = -0.47, p = 0.00001).
Conclusions: The ratio of VC / EVLW, based on an assessment of the absolute values of EVLW, can be considered as an additional criterion of functional operability with extensive lung resection in patients with PPT.
- © 2014 ERS
