Predicted functional respiratory parameters are an important predictor of the postoperative lung morbidity and mortality. But their predictive value for lung resection in pulmonary tuberculosis (PT) remains unstudied. This study assessed a predicted pulmonary function changes effect on the pulmonary complications after pneumonectomy (PE) in PT patients.
Methods: 85 patients after PE (57M/28F, mean age 43.1±11.6 yes) in complex PT treatment were evaluated with complex preoperative measurements of FEV1, TLC, VC, RV, FRCpleth and DLCO. The predicted postoperative (ppo) values were compared with the postoperative complications as per R.J. Korst, duration of the operation and intubation, and the additional medical treatment in the first postoperative week.
Results: Life-threatening surgical (intrapleural bleeding, hemothorax) and pulmonary (acute respiratory distress syndrome) complications were negatively associated with ppo FEV1 (r=-0.39, p<0.05) and positively associated with ppo TLC, RV, FRCpleth (r=0.53, 0.54, 0.63 respectively, p<0.05). The duration of the operation and intubation were also correlated with ppo VC (r=-0.43 and -0.45, p<0.05), FEV1 (r=-0.59 and -0.48, p<0.05) and FRCpleth (r=0.35 and 0.36, p<0.05). There was also a link between the need to prescribe glucocorticosteroids in the first days after surgery and ppo DLCO and DLCO/AO (rs=-0.29, -0.36, respectively, p<0.05).
Conclusions: It was determined that pulmonary complications occurred much more frequently at low ppo values of FEV1 and DLCO and high RV and FRCpleth. Calculating their prognostic values after PE may be especially useful in PT patients with lung function disorders.