Evaluation of respiratory status in patients after thoracic esophagectomy using PiCCO system

Oshima, Kiyohiro, Kunimoto, Fumio, Hinohara, Hiroshi, Hayashi, Yoshiro, Kanemaru, Yoshinori, Takeyoshi, Izumi and Kuwano, Hiroyuki (2008) Evaluation of respiratory status in patients after thoracic esophagectomy using PiCCO system. Annals of Thoracic and Cardiovascular Surgery, 14 5: 283-288.

Author Oshima, Kiyohiro
Kunimoto, Fumio
Hinohara, Hiroshi
Hayashi, Yoshiro
Kanemaru, Yoshinori
Takeyoshi, Izumi
Kuwano, Hiroyuki
Title Evaluation of respiratory status in patients after thoracic esophagectomy using PiCCO system
Journal name Annals of Thoracic and Cardiovascular Surgery   Check publisher's open access policy
ISSN 1341-1098
Publication date 2008-10-01
Sub-type Article (original research)
Volume 14
Issue 5
Start page 283
End page 288
Total pages 6
Place of publication Tokyo, Japan
Publisher Medikaru Toribyun
Language eng
Formatted abstract
Purpose: Thoracic esophagectomy for esophageal cancer is among the most invasive operations, requiring thoracotomy and laparotomy. With regard to postoperative status, the increment of vascular permeability caused by various inflammatory cytokines might influence the postoperative respiratory condition. The PiCCO (pulse contour cardiac output) system (Pulsion Medical Systems AG, Munich, Germany), a new technique based on an arterial thermodilution technique, allows the measurement of extravascular lung water (EVLW). In this study, we hypothesized that EVLW might be a useful parameter to assess the respiratory condition and evaluated respiratory status using values for EVLW after thoracic esophagectomy.
Patients and Methods: The PiCCO system was established in the intensive care unit (ICU) in 25 patients immediately after thoracic esophagectomy for esophageal cancer. EVLWI (EVLW/body weight, normal range: 3-7 ml/kg) was measured on ICU days (ICUD) 1, 2, and 3. The PaO2/FiO 2 (P/F ratio), pulmonary compliance, and lung injury score (LIS) were also calculated, and relationships between EVLWI and those parameters were evaluated.
Results: Mean operating time, blood volume, and fluid balance during surgery were 515 ± 16 (395-690) min, 721 ± 91 (167-1,770) ml, and 3,462 ± 292 (1,892-7,300) ml, respectively. The mean ICU stay was 3.4 ± 0.3 (2-10) days, and all patients were discharged from the ICU without complications. EVLWI gradually increased after surgery with values of 8.6 ± 1.9 ml/kg on ICUD 1, 9.7 ± 2.7 ml/kg on ICUD 2, and 10.0 ± 3.0 ml/kg on ICUD 3. EVLWI was well correlated with P/F ratio (r = -0.358, p = 0.0135), pulmonary compliance (r = -0.625, p = 0.0001), and LIS (r = 0.614, p = 0.0001).
Conclusion: EVLWI may be a useful parameter for evaluation of the respiratory condition after thoracic esophagectomy.
Keyword Thoracic esophagectomy
Respiratory status
Pulse contour cardiac output system
Extravascular lung water
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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Created: Sat, 22 Oct 2011, 00:36:33 EST by Laurie Beechey on behalf of UQ Centre for Clinical Research