Risk factors for acute lung injury after thoracic surgery for lung cancer.

摘要: Acute lung injury (ALI) may complicate thoracic surgery and is a major contributor to postoperative mortality. We analyzed risk factors for ALI in cohort of 879 consecutive patients who underwent pulmonary resections non-small cell carcinoma. Clinical, anesthetic, surgical, radiological, biochemical, histopathologic data were prospectively collected. The total incidence was 4.2% (n 37). In 10 cases, intercurrent complications (bronchopneumonia, n 5; bronchopulmonary fistula, 2; gastric aspiration, thromboembolism, 1) triggered the onset 3 12 days after surgery, this associated with 60% mortality rate (secondary ALI). remaining 27 patients, no clinical adverse event preceded development ALI— 0 surgery—that 26% (primary Four independent primary identified: high intraoperative ventilatory pressure index (odds ratio, 3.5; 95% confidence interval, 1.7– 8.4), excessive fluid infusion 2.9; 1.9 –7.4), pneumonectomy 2.8; 1.4 – 6.3), preoperative alcohol abuse 1.9; 1.1– 4.6). conclusion, we describe two forms postthoracotomy ALI: delayed-onset by 2) an early form amenable risk-reducing strategies, including abstinence, lung-protective modes, limited intake. (Anesth Analg 2003;97:1558 –65)