The Annals of thoracic surgery
-
Comment Letter
Diagnosis of phrenic nerve injury after cardiac surgery.
-
Comparative Study
Use of quantitative lung scintigraphy to predict postoperative pulmonary function in lung cancer patients undergoing lobectomy.
In patients with non-small cell lung cancer, the only realistic chance of cure is surgical resection. However, in some of these patients there is such poor respiratory reserve that surgery can result in an unacceptable quality of life. In order to identify these patients, various pulmonary function tests and scintigraphic techniques have been used. The current American College of Physicians and British Thoracic Society guidelines do not recommend the use of quantitative ventilation-perfusion scintigraphy to predict postoperative function in lung cancer patients undergoing lobectomy. These guidelines may have been influenced by previous scintigraphic studies performed over a decade ago. Since then there have been advances in both surgical techniques and scintigraphic techniques, and the surgical population has become older and more female represented. ⋯ In keeping with current American Chest Physician and British Thoracic Society guidelines, our results suggest that quantitative ventilation-perfusion scintigraphy is not necessary in the preoperative assessment of lung cancer patients undergoing lobectomy. The simple segmenting technique can be used to predict postoperative lung function in lobectomy patients.
-
Case Reports
Combined late diagnosed right main bronchial disruption and chylothorax from blunt chest trauma.
Both main bronchial disruption and chylothorax are uncommon injuries associated with blunt thoracic trauma. We report the case of a patient who presented late after traumatic rupture of the right main bronchus who also had a traumatic chylothorax.
-
Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
Fenoldopam prophylaxis of postoperative acute renal failure in high-risk cardiac surgery patients.
Acute renal failure requiring replacement therapy occurs in 1% to 2% of patients who have undergone cardiac surgery with cardiopulmonary bypass and is associated with a very high mortality rate. The aim of this study was to determine if prophylactic treatment with fenoldopam mesylate of patients at high risk of postoperative acute renal failure reduced the incidence of this event. ⋯ Given the limitations of a nonrandomized prospective trial, our results support the hypothesis that fenoldopam may reduce the risk of acute renal failure in patients in whom endogenous and exogenous cathecolamines action may induce a renal vascular constrictive condition.