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Prediction of hypoxemia after lung resection surgery

¹ First Department of Surgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube Yamaguchi 755-8505, Japan
² Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube Yamaguchi 755-8505, Japan

*Corresponding author. Tel.: +81-836-22-2261; fax: +81-836-22-2260 .

E-mail address: kaueda{at}c-able.ne.jp(K. Ueda).

Pulmonary resection under general anesthesia induces various degrees of hypoxemia that adversely impacts on postoperative recovery. Consecutive of 53 patients undergoing anatomical pulmonary resection were enrolled in this study to accurately define predictors of postoperative hypoxemia. Preoperative variables studied included spirometric variables, blood gases, and extent of low attenuation area (below –910 Hounsfield units) on a three-dimensional computed tomography lung model. Arterial oxygen saturation was calculated from arterial partial pressure of oxygen measured 1 day before and 1 day after surgery with patients at rest breathing room air. Postoperatively, the patients were managed according to a standardized regimen. According to stepwise multiple regression analysis, preoperative oxygen saturation and the extent of low attenuation area were selected as the best predictors of postoperative oxygen saturation. Regression equation was generated with these two variables. The predicted postoperative oxygen saturation was significantly dependent on the length of management (P<0.01). Using a radiographic parameter, we established a novel means of predicting postoperative hypoxemia that impacted on postoperative recovery. Because this radiographic parameter was superior to conventional spirometric variables for prediction of postoperative hypoxemia, further confirmation of its usefulness in predicting risk after pulmonary resection is warranted.

Key Words: Quantitative CT; Pulmonary resection; Low attenuation area; Postoperative hypoxemia; Pulmonary function; Spirometry

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