종례 / 중증 폐기종 환자의 수술적 치료법인 폐용적 감소술 (Lung Volume Reduction Surgery)의 치험 3예

• Published in: Korean journal of anesthesiology Vol. 40; no. 1; pp. 111 - 116
• Main Authors: 김태성, Tae Sung Kim, 김현주, Hyun Ju Kim, 정배희, Bae Hee Jung, 원임수, Rim Soo Won
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 01-01-2001
• Subjects: Emphysema; pulmonary function test; reduction pneumoplasty. Monitoring; spirometry
• ISSN: 2005-6419; 2005-7563

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 (Cγ) 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 (P&T) [FEV, TLC, TG (trapped gas) and FRC] with 3 month postoperative values. Two of the three patients demonstrated post-reduction improvement in dynamic Cγ while only one patient demonstrated post-reduction improvement in V1.0%. All three patients demonstrated an increase in FEV and a decrease in TLC, TG and FRC with the greatest change in one patient who also had a significant reduction in Cγ 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 C and V1.0% could play a role in predicting expected follow-up objective pulmonary function tests; improvement in both Cγ and V1.0% may predict significant improvements in PFT. (Korean J Anesthesiol 2001; 40: 111 ~ 116)