Three Cases of Lung Volume Reduction Surgery in Patients with Severe Emphysema.

Kim,  Tae Sung; Kim,  Hyun Ju; Jung,  Bae Hee; Won,  Rim Soo

doi:2001.40.1.111

Case Report

Korean Journal of Anesthesiology 2001;40(1):111-116.
DOI: https://doi.org/10.4097/kjae.2001.40.1.111

Three Cases of Lung Volume Reduction Surgery in Patients with Severe Emphysema.

Tae Sung Kim, Hyun Ju Kim, Bae Hee Jung, Rim Soo Won

Department of Anesthesiology, Hallym University Medical Center, Seoul, Korea.

Abstract

We have recently experienced with 3 cases of bilateral lung volume reduction surgery (LVRS) in patients with severe emphysematous disease in an effort to improve pulmonary mechanics. We compared intraoperative total dynamic lung compliance (CT) and % of breath exhaled in one second (V1.0%) obtained immediately pre-lung reduction and immediate post-lung reduction. In addition we also compared preoperative pulmonary function test (PFT) [FEV1, TLC, TG (trapped gas) and FRC] with 3 month postoperative values. Two of the three patients demonstrated post-reduction improvement in dynamic CT while only one patient demonstrated post-reduction improvement in V1.0%. All three patients demonstrated an increase in FEV1 and a decrease in TLC, TG and FRC with the greatest change in one patient who also had a significant reduction in CT and an improvement in V1.0% intraoperatively, and post-lung reduction. Although our results of the 3 cases are preliminary, it appears that side stream spirometry with immediate intraoperative measurement of dynamic CT and V1.0% could play a role in predicting expected follow-up objective pulmonary function tests; improvement in both CT and V1.0% may predict significant improvements in PFT.

Key Words: Emphysema: reduction pneumoplasty; Monitoring: spirometry; pulmonary function test