PDF herunterladen
Thorac Cardiovasc Surg 2005; 53(4): 245-249
DOI: 10.1055/s-2005-837646
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Lung Function in Patients Operated for Chronic Pleural Empyema

W. Rzyman1 , J. Skokowski1 , G. Romanowicz2 , P. Lass2 , M. Murawski1 , M. Taraszewska3 , R. Dziadziuszko4
  • 1Department of Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland
  • 2Department of Nuclear Medicine, Medical University of Gdansk, Gdansk, Poland
  • 3Department of Radiology, Medical University of Gdansk, Gdansk, Poland
  • 4Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
Weitere Informationen

Publikationsverlauf

Received December 9, 2004

Publikationsdatum:
22. Juli 2005 (online)

    Lizenzen und Reprints Alle Artikel dieser Rubrik

Abstract

Objectives: To evaluate lung function after lung decortication in patients operated for chronic pleural empyema. Methods and Materials: To determine the lung function after lung decortication in 20 men (71.4 %) and 8 women (28.6 %) a prospective evaluation of blood gases, spirometry, lung perfusion, ventilation, and alveolar permeability were performed 28 weeks (15 - 60 weeks) after the operation. Results: Median lung perfusion on the affected side was 45.2 % (26.1 - 55.3 %) in 13 right and 36 % (13.8 - 47.2 %) in 15 left empyemas, and was within normal limits in 4/28 cases. The mean lung ventilation was 44.4 % (21.5 - 54 %) and 37 % (18.9 - 50.6 %) in patients affected on the right or left side, respectively. Ventilation perfusion inequality occurred in 22 patients (78.6 %). Dynamic ventilation scintigraphy revealed impairment of epithelial integrity in 10 cases (35.7 %). Individual analysis revealed that 15 patients (53.6 %) showed a severe reduction in one of the examinations and 8 (28.6 %) in more than one. Conclusions: Although the separate analysis of the different functional parameters revealed a mild reduction of lung function after decortication, in the majority of patients the impairment was more severe due to multilevel functional lung damage.

Key words

Chronic pleural empyema - lung function - lung decortication - scintigraphy

References

  • 1 Ahmed F A, Harrison C V. The effect of prolonged pulmonary collapse on the pulmonary arteries.  J Path Bact. 1963;  85 357-360
    CrossrefPubMedSuche in Google Scholar
  • 2 Björk V O, Salen E F. The blood flow through an atelectatic lung.  J Thorac Cardiovasc Surg. 1950;  20 933-942
    PubMedSuche in Google Scholar
  • 3 Benfield J R, Long E T, Harrison R W. et al . Should a chronic atelectatic lung be re-aerated or excised?.  Dis Chest. 1960;  37 67-74
    PubMedSuche in Google Scholar
  • 4 Long E T, Adams W E, Benfield J E. et al . Altered hemodynamics in the pulmonary circulation following re-aeration of an atelectatic lung.  J Thorac Cardiovasc Surg. 1960;  40 640-651
    PubMedSuche in Google Scholar
  • 5 Morton J R, Boushy S F, Guinn G E. Physiological evaluation of results of pulmonary decortication.  Ann Thorac Surg. 1970;  9 321-326
    PubMedSuche in Google Scholar
  • 6 Petro W, Maassen W, Greschuchna D. et al . Regional and global lung function in unilateral fibrothorax after conservative therapy and decortication.  Thorac Cardiovasc Surg. 1989;  30 137-141
    PubMedSuche in Google Scholar
  • 7 Swoboda L, Laule K, Blattmann H. et al . Decortication in chronic pleural empyema. Investigation of lung function based on perfusion scintigraphy.  Thorac Cardiovasc Surg. 1990;  38 359-361
    Thieme ConnectPubMedSuche in Google Scholar
  • 8 Thomas G I, Jarvis F J. Decortication in primary tuberculous pleuritis and empyema with a study of functional recovery.  J Thorac Surg. 1956;  32 178-189
    PubMedSuche in Google Scholar
  • 9 Toomes H, Vogt-Moykopf I, Ahrendt J. Decortication of the lung.  Thorac Cardiovasc Surg. 1983;  31 338-341
    Thieme ConnectPubMedSuche in Google Scholar
  • 10 Toomes H, Linder A, Friedel G. Funktionelle Aspekte des Pleuraempyems und der Pleuraschwiele.  Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir. 1989;  199-202
    PubMedSuche in Google Scholar
  • 11 Skokowski J, Rzyman W, Brasławska J. Traumatic rupture of the left main bronchus - late surgical treatment.  Ann Acad Med Gedan. 1994;  24 101-103
    PubMedSuche in Google Scholar
  • 12 Wolfart W. Szintigraphische Untersuchungen vor und nach Dekortikation der Lunge.  Thoraxchirurgie. 1974;  22 435-439
    PubMedSuche in Google Scholar
  • 13 Wójcik J, Sedlaczek A, Grodzki T. et al . Pulmonary flow in patients subjected to lung decortication due to chronic pleural empyema.  Pol Przegl Chir. 1998;  70 29-37
    PubMedSuche in Google Scholar
  • 14 Rzyman W, Romanowicz G, Skokowski J. et al . Decortication in chronic pleural empyema: Effect on lung function.  Eur J Cardiothorac Surg. 2002;  21 502-507
    CrossrefPubMedSuche in Google Scholar
  • 15 Standardised lung function testing. Interim Report of the Working Party “Standardisation of Lung Function Tests” of the European Community for Coal and Steel. Luxembourg; European Community for Coal and Steel 1981
    Suche in Google Scholar
  • 16 Dusser D, Collignon M AG, Leguern G S. et al . Respiratory clearance of DTPA and pulmonary involvement in sarcoidosis.  Am Rev Resp Dis. 1986;  3 493-497
    PubMedSuche in Google Scholar
  • 17 Cotes J E. Lung Function. Warszawa; PZWL 1969
    Suche in Google Scholar
  • 18 Slome D. Physiology of respiration. Evans FT, Gray TC General Anaesthesiology. Warszawa; PZWL 1970: 55-140
    Suche in Google Scholar
  • 19 Konietzko N, Brandstetter F, Steinberg. Die gefesselte Lunge - Ergebnisse der Dekortikation. Atemwegs- u.  Lungenkrankheiten. 1980;  6 191-200
    PubMedSuche in Google Scholar
  • 20 Chan T L, Lippmann M. Experimental measurements and empirical modelling of the regional deposition of inhaled particles in humans.  Am Ind Hyg Assoc J. 1980;  41 399-409
    PubMedSuche in Google Scholar

M.D. Ph.D. Witold Rzyman

Thoracic Surgery Department
Medical University of Gdansk

Ul. Dębinki 7

80-211Gdansk

Poland

Telefon: + 48583492400

Fax: + 48 5 83 49 24 29

eMail: wrzyman@amg.gda.pl