Quantitation of regional ventilation during the washout phase of lung scintigraphy: measurement in patients with severe COPD before and after bilateral lung volume reduction surgery.
Chest
; 118(3): 721-7, 2000 Sep.
Article
em En
| MEDLINE
| ID: mdl-10988194
ABSTRACT
STUDY OBJECTIVES:
We sought to investigate the effect of lung volume reduction surgery (LVRS) on regional lung ventilation.DESIGN:
Retrospective analysis of routinely acquired data before and after LVRS.SETTING:
Large, urban, university medical center. PATIENTS Twenty-nine patients with severe emphysema. INTERVENTION Bilateral LVRS. MEASUREMENTS ANDRESULTS:
(133)Xe washout curves during lung scintigraphy exhibit a biphasic pattern (the first component of the washout curve [m(r)] corresponds to an initial rapid phase in washout that reflects larger airways emptying, and the second component [m(s)] reflects a slower phase of washout that is attributed to gas elimination via smaller airways). We analyzed six standardized regions of the lung (upper, mid, and lower zones of the right and left lung), and calculated m(r) and m(s) for each lung region. The mean (+/- SE) baseline FEV(1) was 0.69+/-0.04 L, total lung capacity (TLC) was 139 +/-4% predicted, and the residual volume (RV)/TLC ratio was 65+/-2%. The mean improvement in FEV(1) 3 months post-LVRS was 38%. Post-LVRS, m(r) and m(s) increased in 79 and 74 lung regions, respectively, and there was no relationship with respect to lung regions that had or had not been operated on. The increase in m(s), however, significantly correlated with the increase in FEV(1) (r = 0.66; p<0.0001) and the decrease in RV/TLC (r = -0.67; p<0.0001). An increase in m(s) also correlated with a decrease in PaCO(2) (r = -0.39; p = 0.03), but m(r) showed no relationship with any parameter.CONCLUSIONS:
Small airways ventilation in lung regions that had and had not been operated on is associated with a greater improvement in lung mechanics following LVRS.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonectomia
/
Ventilação Pulmonar
/
Pneumopatias Obstrutivas
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Chest
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Estados Unidos