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Wu D, Wang L, Zhang L. Efficacy and safety of step-by-step Baduanjin exercise based on doctor-nurse-patient integration mode for pulmonary rehabilitation in patients after lobectomy due to pulmonary tuberculosis: a randomized controlled clinical trial. J Cardiothorac Surg 2024; 19:520. [PMID: 39252121 PMCID: PMC11382401 DOI: 10.1186/s13019-024-03042-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 08/31/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Some pulmonary tuberculosis patients may require lung resection surgery. Postoperative pulmonary rehabilitation is essential to restore the lung function and maintain quality of life. We aimed to study the pulmonary rehabilitation outcomes and complications of step-by-step Baduanjin exercise under a doctor-nurse-patient integration mode in patients after lobectomy due to pulmonary tuberculosis. METHODS We performed a randomized controlled clinical trial in patients undergoing lobectomy due to pulmonary tuberculosis between September 2017 and August 2021. Eligible patients were randomly assigned into the control group or interventional group. The control group received routine postoperative care. The interventional group received step-by-step Baduanjin exercise based on the doctor-nurse-patient integration mode in addition to the routine care. The primary outcomes were the pulmonary functions, including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC. The secondary outcomes were the maximum walking distance in a 6-min walk test and postoperative pulmonary complications, including atelectasis, pneumonia, and respiratory failure. RESULTS A total of 100 patients were enrolled into the study, with 50 patients in the control and interventional groups. There were 60 female patients (60%). The mean patient age was 37.9 (± 2.8) years old. At the one- and two-month postoperative follow-ups, pulmonary function tests showed statistically significantly better performances in FEV1/prediction, FVC/prediction, and FEV1/FVC in the interventional group than the control group. The 6-min walk test also revealed longer walking distances in the interventional group than the control group. There were no statistically significant differences in postoperative complications between the two groups. CONCLUSIONS A step-by-step Baduanjin exercise regimen under the doctor-nurse-patient integration mode could safely improve pulmonary rehabilitation in patients after lobectomy due to pulmonary tuberculosis.
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Affiliation(s)
- Dengzhu Wu
- Department of Tuberculosis Intensive Care Unit, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, 208 Huancheng Road East, Hangzhou, 310003, Zhejiang Province, China
| | - Linghua Wang
- Department of Tuberculosis Intensive Care Unit, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, 208 Huancheng Road East, Hangzhou, 310003, Zhejiang Province, China
| | - Lin Zhang
- Department of Tuberculosis Intensive Care Unit, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, 208 Huancheng Road East, Hangzhou, 310003, Zhejiang Province, China.
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Zhao J, Cao X, Li Y, Yan D, Liu F, Lin S, Ruan H. Prognostic analysis of destroyed-lung patients with preoperative massive hemoptysis: a 20-year retrospective study. BMC Pulm Med 2024; 24:402. [PMID: 39169381 PMCID: PMC11340151 DOI: 10.1186/s12890-024-03205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 08/07/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Surgery is the main treatment option for destroyed-lung (DL) patients with life-threatening massive hemoptysis. However, short-term and long-term surgical safety and efficacy are unclear, prompting this study. METHODS Data from 124 DL patients undergoing surgery between November 2001 and January 2022 at Beijing Chest Hospital were retrospectively analyzed. Data of the DL group (82 cases) and DL + massive hemoptysis group (42 cases) were compared with regard to clinical characteristics, long-term postoperative residual lung reinfection. RESULTS As compared with DL group rates, The DL + massive hemoptysis group had greater incidence rates of postoperative complications, invasive postoperative respiratory support, long-term postoperative residual lung reinfection, and postoperative tuberculosis recurrence. Revealed risk factors for postoperative complications (Extent of lung lesion resection), postoperative invasive respiratory therapy (preoperative Hb < 9 g/L, severe intraoperative hemoptysis), and postoperative long-term residual lung reinfection (DL with massive hemoptysis). CONCLUSIONS DL patients with massive hemoptysis had greater rate of invasive respiratory support therapy and postoperative complications. Extensive lesion removal, preoperative anaemia, severe intraoperative bleeding associated with recent postoperative complications for the patient.
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Affiliation(s)
- Jing Zhao
- Department of Anesthesia, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, P. R. China
| | - Xiaoman Cao
- Department of Anesthesia, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, P. R. China
| | - Yunsong Li
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, P. R. China
| | - Dongjie Yan
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, P. R. China
| | - Fangchao Liu
- Department of Science and Technology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China.
| | - Shuye Lin
- Department of Cellular and Molecular Biology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China.
| | - HongYun Ruan
- Department of Cellular and Molecular Biology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China.
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Bansal N, Arunachala S, Kaleem Ullah M, Kulkarni S, Ravindran S, ShankaraSetty RV, Malamardi S, Chaya SK, Lokesh KS, Parthasarathi A, Shyam Prasad Shetty B, Chikkahonnaiah P, Vishwanath P, Siddaiah JB, Mahesh PA. Unveiling Silent Consequences: Impact of Pulmonary Tuberculosis on Lung Health and Functional Wellbeing after Treatment. J Clin Med 2024; 13:4115. [PMID: 39064155 PMCID: PMC11278349 DOI: 10.3390/jcm13144115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Pulmonary tuberculosis (TB) remains a major public health issue in India, with high incidence and mortality. The current literature on post-TB sequelae functional defects focuses heavily on spirometry, with conflicting obstruction vs. restriction data, lacks advanced statistical analysis, and has insufficient data on diffusion limitation and functional impairment. Objective: This study aimed to thoroughly evaluate post-tubercular sequelae after treatment, assessing chest radiology, spirometry, diffusing capacity, and exercise capacity. Methods: A total of 85 patients were studied at a university teaching hospital in Mysuru. The data collected included characteristics, comorbidities, smoking history, and respiratory symptoms. The investigations included spirometry, DLCO, chest X-rays with scoring, and 6MWT. Results: Of the patients, 70% had abnormal X-rays post-treatment, correlating with reduced lung function. Additionally, 70% had impaired spirometry with obstructive/restrictive patterns, and 62.2% had reduced DLCO, with females at higher risk. Smoking increased the risk of sequelae. Conclusions: Most patients had residual radiological/lung function abnormalities post-treatment. Advanced analyses provide insights into obstructive vs. restrictive defects. Ongoing research should explore pathogenetic mechanisms and therapeutic modalities to minimize long-term post-TB disability.
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Affiliation(s)
- Nidhi Bansal
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
| | - Sumalatha Arunachala
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
- Department of Critical Care Medicine, Adichunchanagiri Institute of Medical Sciences, Bellur 571448, India
- Department of Critical Care, ClearMedi Multispecialty Hospital, Mysuru 570017, India
| | - Mohammed Kaleem Ullah
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (M.K.U.); (P.V.)
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Shreedhar Kulkarni
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
| | - Sukanya Ravindran
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
| | - Rekha Vaddarahalli ShankaraSetty
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
| | - Sowmya Malamardi
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
- School of Psychology & Public Health, College of Science Health and Engineering, La Trobe University, Melbourne 3086, Australia
| | - Sindaghatta Krishnarao Chaya
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
| | - Komarla Sundararaja Lokesh
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
| | - Ashwaghosha Parthasarathi
- Rutgers University Institute for Health, Healthcare Policy, and Aging Research, The State University of New Jersey, 112 Paterson Street, New Brunswick, NJ 08901, USA;
| | - Bellipady Shyam Prasad Shetty
- Department of Cardiothoracic & Vascular Surgery, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India;
| | - Prashanth Chikkahonnaiah
- Department of Respiratory Diseases, Princess Krishnajammanni Tuberculosis and Chest Diseases Hospital, Mysuru 570002, India;
| | - Prashant Vishwanath
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (M.K.U.); (P.V.)
| | - Jayaraj Biligere Siddaiah
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
| | - Padukudru Anand Mahesh
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysuru 570015, India; (N.B.); (S.A.); (S.K.); (S.R.); (S.M.); (S.K.C.); (K.S.L.); (J.B.S.)
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Zhao J, Cao X, Li Y, Li Y, Ma T, Liu F, Ruan H. Analysis of clinical characteristics of different types of lung function impaiement in TDL patients. BMC Pulm Med 2024; 24:292. [PMID: 38914991 PMCID: PMC11194949 DOI: 10.1186/s12890-024-03115-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
AIM The clinical characteristics associated with pulmonary function decline in patients with Tuberculosis-destroyed lung (TDL) remain uncertain. We categorize them based on the pattern of pulmonary function impairment, distinguishing between restrictive spirometric pattern (RSP) and obstructive spirometric pattern (OSP). We aim to compare the severity of these patterns with the clinical characteristics of TDL patients and analyze their correlation. METHOD We conducted a retrospective analysis on the clinical data of TDL patients who underwent consecutive pulmonary function tests (PFT) from November 2002 to February 2023. We used the lower limit formula for normal values based on the 2012 Global Lung Function Initiative. We compared the clinical characteristics of RSP patients with those of OSP patients. The characteristics of RSP patients were analyzed using the tertiles of forced vital capacity percentage predicted (FVC% pred) decline based on PFT measurements, and the characteristics of OSP patients were analyzed using the tertiles of forced expiratory volume in 1 s percentage predicted (FEV1% pred) decline. RESULT Among the RSP patients, those in the Tertile1 group (with lower FVC% pred) were more likely to have a higher of body mass index (BMI), spinal deformities, and C-reactive protein (CRP) compared to the other two groups (P for trend < 0.001, 0.027, and 0.013, respectively). Among OSP patients, those in the Tertile1 group (with lower FEV1% pred) showed an increasing trend in cough symptoms and contralateral lung infection compared to the Tertile 2-3 group (P for trend 0.036 and 0.009, respectively). CONCLUSION For TDL patients, we observed that Patients with high BMI, a higher proportion of spinal scoliosis, and abnormal elevation of CRP levels were more likely to have reduced FVC. Patients with decreased FEV1% pred have more frequent cough symptoms and a higher proportion of lung infections on the affected side.
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Affiliation(s)
- Jing Zhao
- Department of anesthesia, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, P. R. China
| | - Xiaoman Cao
- Department of anesthesia, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, P. R. China
| | - YunSong Li
- Department of Thoracic Surgery, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, P. R. China
| | - Yang Li
- Department of General, Changchun Infectious Disease Hospital, Changchun city, Jilin, P. R. China
| | - Teng Ma
- Department of Cellular and Molecular Biology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, P. R. China.
- , No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China.
| | - Fangchao Liu
- Department of Science and Technology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, P. R. China.
| | - Hongyun Ruan
- Department of Cellular and Molecular Biology, Beijing Chest Hospital, Beijing Tuberculosis and Thoracic Tumor Research Institute, Capital Medical University, Beijing, P. R. China.
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Mu S, Chen Y, Wang J, Guo J, Niu R, Zhang Y, Su P, Ali JM, Gao J, Wu A. The predictive and prognostic value of risk factors in patients receiving hybrid coronary revascularization with postoperative pulmonary complications. J Thorac Dis 2024; 16:2528-2538. [PMID: 38738248 PMCID: PMC11087606 DOI: 10.21037/jtd-24-422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/10/2024] [Indexed: 05/14/2024]
Abstract
Background The mortality rate of coronary artery disease ranks first in developed countries, and coronary revascularization therapy is an important cornerstone of its treatment. The postoperative pulmonary complications (PPCs) in patients receiving one-stop hybrid coronary revascularization (HCR) aggravate the dysfunction of multiple organs such as the heart and lungs, therefore increasing mortality. However, the risk factors are still unclear. The objective of this study was to explore the risk factors of PPCs after HCR surgery. Methods In this study, the perioperative data of 311 patients undergoing HCR surgery were reviewed. All patients were divided into two groups according to whether the PPCs occurred. The baseline information and surgery-related indicators in preoperative laboratory examination, intraoperative fluid management, and anesthesia management were compared between the two groups. Results Advanced age [odds ratio (OR): 1.065, 95% confidence interval (CI): 1.030-1.101, P<0.001], high body mass index (BMI; OR: 1.113, 95% CI: 1.011-1.225, P=0.02), history of percutaneous coronary intervention (PCI) surgery (OR: 2.831, 95% CI: 1.388-5.775, P=0.004), one-lung volume ventilation (OR: 3.804, 95% CI: 1.923-7.526, P<0.001), inhalation of high concentration oxygen (OR: 3.666, 95% CI: 1.719-7.815, P=0.001), the application of positive end-expiratory pressure (PEEP; OR: 2.567, 95% CI: 1.338-4.926, P=0.005), and long one-lung ventilation time (OR: 1.015, 95% CI: 1.006-1.023, P=0.001) may be risk factors for postoperative PPCs in patients undergoing one-stop coronary revascularization surgery. Using the above seven factors to jointly predict the risk of PPCs in patients undergoing one-stop coronary revascularization surgery, the receiver operating characteristic (ROC) curve showed an area under the curve (AUC) =0.873, 95% CI: 0.835-0.911, sensitivity: 84.81%, and specificity: 75.82%; the predictive model was shown to be effective. Conclusions Patients undergoing HCR surgery with advanced age, high BMI, a history of PCI surgery, one-lung volume ventilation, inhalation of high concentration oxygen, use of PEEP, and prolonged single lung ventilation are more prone to PPCs.
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Affiliation(s)
- Shanshan Mu
- Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Yingqi Chen
- Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Jiawan Wang
- Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Jingjing Guo
- Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Ruitong Niu
- Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Yang Zhang
- Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Pixiong Su
- Department of Cardiac Surgery, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Jason M. Ali
- Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, UK
| | - Jie Gao
- Department of Cardiac Surgery, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
| | - Anshi Wu
- Department of Anesthesiology, Beijing Chaoyang Hospital of Capital Medical University, Beijing, China
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Liu L, Wang X, Luo L, Liu X, Chen J. Risk Factors of Tuberculosis Destroyed Lung in Patients with Pulmonary Tuberculosis and Structural Lung Diseases: A Retrospective Observational Study. Risk Manag Healthc Policy 2024; 17:753-762. [PMID: 38567384 PMCID: PMC10985215 DOI: 10.2147/rmhp.s448765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Tuberculosis destroyed lung constitutes a significant worldwide public health challenge, little is known about its associated risk factors and prognosis. Our study aimed to identify the risk factors of tuberculosis destroyed lung among pulmonary tuberculosis and structural lung diseases. Methods Between January 2019 and December 2021, a case-control study was conducted at the Third People's Hospital of Shenzhen in China. We collected the clinical data among patients with pulmonary tuberculosis and structural lung diseases. Cases were defined as patients with tuberculosis destroyed lung. Controls were not diagnosed with the tuberculosis destroyed lung. A binary logistic regression was performed. Results In our study, a total of 341 patients met the inclusion criteria, including 182 cases and 159 controls. We found that age ranges of 46-60 years (aOR: 4.879; 95% CI: 2.338-10.180), >60 years (aOR: 3.384; 95% CI: 1.481-7.735); history of TB treatment (aOR: 2.729; 95% CI: 1.606-4.638); malnutrition (aOR: 5.126; 95% CI: 1.359-19.335); respiratory failure (aOR: 5.080; 95% CI: 1.491-17.306); and bronchiarctia (aOR: 3.499; 95% CI: 1.330-9.209) were the independent risk factors for tuberculosis destroyed lung. Conversely, having a normal (aOR: 0.207; 95% CI: 0.116-0.371) or overweight BMI (aOR: 0.259; 95% CI: 0.090-0.747) emerged as a protective factor against tuberculosis destroyed lung. Conclusion This study indicated that tuberculosis destroyed lung is a common condition among patients with pulmonary tuberculosis and structural lung diseases. The independent risk factors for tuberculosis destroyed lung were identified as being within the age groups of 46-60 and over 60 years, having a previous history of TB treatment, malnutrition, respiratory failure, and bronchiarctia. It is essential to closely monitor patients possessing these risk factors to prevent the progression towards tuberculosis destroyed lung.
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Affiliation(s)
- Linlin Liu
- Hengyang Medical School, School of Nursing, University of South China, Hengyang, People’s Republic of China
| | - Xiufen Wang
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
| | - Li Luo
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
| | - Xuhui Liu
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
| | - Jingfang Chen
- Hengyang Medical School, School of Nursing, University of South China, Hengyang, People’s Republic of China
- Department of the Third Pulmonary Disease, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China
- National Clinical Research Center for Infectious Diseases, Shenzhen, People’s Republic of China
- Faculty of Medicine, Macau University of Science and Technology, Macau, People’s Republic of China
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Li W, Zhao J, Gong C, Zhou R, Yan D, Ruan H, Liu F. Value of preoperative evaluation of FEV 1 in patients with destroyed lung undergoing pneumonectomy - a 20-year real-world study. BMC Pulm Med 2024; 24:39. [PMID: 38233903 PMCID: PMC10795229 DOI: 10.1186/s12890-024-02858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Clinical guidelines recommend a preoperative forced expiratory volume in one second (FEV1) of > 2 L as an indication for left or right pneumonectomy. This study compares the safety and long-term prognosis of pneumonectomy for destroyed lung (DL) patients with FEV1 ≤ 2 L or > 2 L. METHODS A total of 123 DL patients who underwent pneumonectomy between November 2002 and February 2023 at the Department of Thoracic Surgery, Beijing Chest Hospital were included. Patients were sorted into two groups: the FEV1 > 2 L group (n = 30) or the FEV1 ≤ 2 L group (n = 96). Clinical characteristics and rates of mortality, complications within 30 days after surgery, long-term mortality, occurrence of residual lung infection/tuberculosis (TB), bronchopleural fistula/empyema, readmission by last follow-up visit, and modified Medical Research Council (mMRC) dyspnea scores were compared between groups. RESULTS A total of 96.7% (119/123) of patients were successfully discharged, with 75.6% (93/123) in the FEV1 ≤ 2 L group. As compared to the FEV1 > 2 L group, the FEV1 ≤ 2 L group exhibited significantly lower proportions of males, patients with smoking histories, patients with lung cavities as revealed by chest imaging findings, and patients with lower forced vital capacity as a percentage of predicted values (FVC%pred) (P values of 0.001, 0.027, and 0.023, 0.003, respectively). No significant intergroup differences were observed in rates of mortality within 30 days after surgery, incidence of postoperative complications, long-term mortality, occurrence of residual lung infection/TB, bronchopleural fistula/empyema, mMRC ≥ 1 at the last follow-up visit, and postoperative readmission (P > 0.05). CONCLUSIONS As most DL patients planning to undergo left/right pneumonectomy have a preoperative FEV1 ≤ 2 L, the procedure is generally safe with favourable short- and long-term prognoses for these patients. Consequently, the results of this study suggest that DL patient preoperative FEV1 > 2 L should not be utilised as an exclusion criterion for pneumonectomy.
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Affiliation(s)
- Wenbo Li
- Faculty of Health and Life Science, The University of Exeter, Exeter, UK
| | - Jing Zhao
- Department of Anesthesia, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, P. R. China
| | - Changfan Gong
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China
| | - Ran Zhou
- Department of General Medicine, Qingdao Chest Hospital, Qingdao, P. R. China
| | - Dongjie Yan
- Department of Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China.
| | - Hongyun Ruan
- Department of Cellular and Molecular Biology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China.
| | - Fangchao Liu
- Department of Science and Technology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, No 9, Bei guan Street, Tong Zhou District, Beijing, 101149, P. R. China.
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Ruan H, Liu F, Li Y, Wang Y, Hou D, Yang X, Liu B, Ma T, Liu Z. Long-term follow-up of tuberculosis-destroyed lung patients after surgical treatment. BMC Pulm Med 2022; 22:346. [PMID: 36104786 PMCID: PMC9476694 DOI: 10.1186/s12890-022-02139-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To monitor dypsnea and mortality at 5 and 10 years, respectively, after surgical treatment of tuberculosis-destroyed lung (TDL) patients.
Methods
TDL patients treated surgically at Beijing Chest Hospital from November 2007 to June 2019 were monitored in this observational study. Follow-up assessments of respiratory function indicators and survival conducted 5 and 10 years post-surgery led to patient grouping based on mMRC score into a dyspnea group (mMRC ≥ 1) and a non-dyspnea group (mMRC = 0). Cox regression analysis detected effects of patient demographics, clinical characteristics, surgical factors and respiratory function on 5 year post-surgical survival.
Results
By study completion (June 30, 2020), 32 of 104 patients were lost and 72 completed follow-up for a study total of 258.9 person-years. 45 patients (62.5%, 45/72) had mMRC scores of 0, while 12 (16.7%, 12/72), 21 (36.2%, 21/58) and 27 (60.0%, 27/45) patients exhibited dyspnea by 1, 3 and 5 years post-surgery, respectively. Low lung carbon monoxide diffusion score (DLCO% pred) and scoliosis contributed to dyspnea occurrence.
Conclusions
Most TDL patients lacked subjective dyspnea signs post-surgery, while dyspnea rates increased with time. Preoperative low lung diffusion function and Scoliosis were associated with factors for postoperative dyspnea. Surgical treatment increased TDL patient survival overall.
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Ruan H, Lin S, Liu F, Zhao C, Gong C, Li Y, Wang J, Yang X. Key Factors Associated With Administration of Ventilator Support After Thymoma Resection. J Surg Res 2022; 277:67-75. [DOI: 10.1016/j.jss.2022.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 02/18/2022] [Accepted: 03/19/2022] [Indexed: 11/30/2022]
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