Respiratory mechanics and fluid dynamics after lung resection surgery.
Respiratory mechanics and fluid dynamics after lung resection surgery.
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DOI：
10.1016/j.thorsurg.2010.03.001
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发表时间：
2010-08-01
影响因子：
2.1
通讯作者：
Rivolta, Ilaria
中科院分区：
文献类型：
--
作者：
Miserocchi, Giuseppe;Beretta, Egidio;Rivolta, Ilaria
胸外科手术需要切除部分肺或全肺，它深刻地改变了肺-胸壁连接的机械和流体动力学设置，以及胸腔和剩余肺的水分平衡。最常见的术后并发症是呼吸系统并发症，其发生率随着术前呼吸状况的恶化而增加。显然有必要确定主要与呼吸功能有关的危险因素，而不忽视其他合并症的重要性，如冠状动脉疾病。然而，目前尚缺乏一个令人满意的预测术后心肺并发症的指标；术后发病率和死亡率在过去10年中保持不变。本综述的目的是根据与肺液动力学和力学有关的新概念，对呼吸系统的主要呼吸道并发症提供病理生理学解释。提出了新的参数，以改进从术前到术后早期的呼吸功能评估，因为大多数并发症都发生在这段时间。
Thoracic surgery that requires resection of a portion of lung or of a whole lung profoundly alters the mechanical and fluid dynamic setting of the lung-chest wall coupling, as well as the water balance in the pleural space and in the remaining lung. The most frequent postoperative complications are of a respiratory nature, and their incidence increases the more the preoperative respiratory condition seems compromised. There is an obvious need to identify risk factors concerning mainly the respiratory function, without neglecting the importance of other comorbidities, such as coronary disease. At present, however, a satisfactory predictor of postoperative cardiopulmonary complications is lacking; postoperative morbidity and mortality have remained unchanged in the last 10 years. The aim of this review is to provide a pathophysiologic interpretation of the main respiratory complications of a respiratory nature by relying on new concepts relating to lung fluid dynamics and mechanics. New parameters are proposed to improve evaluation of respiratory function from pre- to the early postoperative period when most of the complications occur.