Objective To assess the value of pulmonary ventilation test in evaluating the prognosis of cardiac surgery patients. Methods Data were collected retrospectively from consecutive patients with coronary heart disease or valvular disease, who were prepared for cardiac surgery in Zhongshan Hospital from January 2007 to December 2008. The main outcome indices were mortality of surgery, the prolonging time of using artificial airway ( ≥3 days) , and the prolonging time in intensive care units ( ICU) ( ≥5 days) . Then the relationship between the poor outcome and ventilation disorder was analyzed. Results In the 422 cases,the incidence of ventilation disorder was 55% , included 27. 5% restrictive ventilation disorder, 15. 6% obstructive ventilation disorder, and 11. 8% mixed ventilation disorder. And the severity of pulmonaryventilation disorder was mild of 34. 6% , moderate of 15. 2% , and severe of 5. 2% . Among the 42 patients who gave up surgery,50% were due to ventilation dysfunction, and the patients were prone to give up surgery with the deterioration of pulmonary function( P lt; 0. 001) . But comparing with the patients with normal pulmonary function, the risk of poor outcome after surgery did not significantly increase in the patients with ventilation disorder ( P gt; 0. 05 ) . The logistic regression analysis indicated that cardiopulmonary bypass ( CPB) was an absolute risk factor ( P lt; 0. 05) . Conclusions The incidence of ventilation disorder in patients with cardiac disease is quite high. Severe pulmonary ventilation disorder is the significant cause of giving up surgery, but may be not the absolute contraindication of cardiac surgery.
Objective To explore the prognostic value of preoperative pulmonary ventilation function for postoperative survival of patients with non-small cell lung cancer ( NSCLC) . Methods 146 NSCLC patients who underwent cured lung surgical resection between January 1, 2003 and December 31,2008 in Nanjing Drum Tower Hospital were recruited in the study. Pulmonary ventilation function was obtained preoperatively for each patient, including vital capacity ( VC) , forced vital capacity ( FVC) , forcedexpiratory volume in 1 second ( FEV1 ) , FEV1 /FVC, and peak expiratory flow ( PEF) . The effects of the above lung function variables on postoperative survival were evaluated by both univariate and multivariate Cox proportional hazard models. Kaplan-Meier method was used to assess the survival probabilities betweendifferent groups.Results The median survival time after surgery was 31. 0 months ( 95% CI 22. 55-39. 45) . VC% pred, FVC% pred and FEV1% pred showed significant associations with the risk of mortality in the NSCLC patients after surgery ( hazard ratios 0. 979-0. 981, P lt; 0. 05) . The survival time after surgery was significantly shorter in the patients with VC ≤ 80% predicted compared to those with VC gt; 80% predicted ( median survival time: 31. 0 months vs. 34. 0 months) . The same difference could be found between the patients with FVC≤80% predicted and those with FVC gt; 80% predicted ( median survival time: 27. 0 months vs. 43. 0 months) . There was also significant difference in median survival between the patients with FEV1 ≤80% predicted and those with FEV1 gt; 80% predicted ( median survival time: 17. 0 months vs. 44. 0 months) . Conclusion Preoperative pulmonary ventilation function parameters may be used to informclinical decisions and indicate the prognosis of NSCLC patients after surgery.
ObjectiveTo investigate the relationship between pulmonary ventilation function (obstructive and restrictive ventilation dysfunction) and atherosclerosis, and explore the correlation between brachial-ankle pulse wave velocity (ba-PWV, an effective index for evaluating atherosclerosis) and pulmonary ventilation function.MethodsFrom January to August 2018, a total of 6403 healthy subjects who reported no major chronic diseases such as stroke, myocardial infarction, cor pulmonale or malignant tumor were selected. Past history such as smoking history, hypertension, diabetes, blood biochemistry, and blood hypersensitive C reactive protein (hs-CRP), hemodynamic indexes such as systolic pressure, diastolic pressure and ba-PWV, body measurement indexes such as height, weight, waist circumference and pulmonary ventilation function were collected. The relationship between ba-PWV and pulmonary ventilation function were evaluated.ResultsA total of 2433 subjects were included, including 916 males and 1517 females. Ba-PWV showed significant positive correlations with age, smoking index, waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, cholesterol, low density lipoprotein, hs-CRP, glycosylated hemoglobin, and significant negative correlations with height, percentage of forced vital capacity (FVC) in the predicted value (FVC%pred), forced expiratory volume in one second (FEV1), percentage of FEV1 in the predicted value (FEV1%pred), FEV1/FVC ratio and percentage of maximun midexpiratory flow (MMEF) in the predicted value (MMEF%pred). The ba-PWV was not correlated with weight, body mass index, FVC, MMEF, γ-glutamyl transpeptidase, high density lipoprotein, creatinine or uric acid. In multiple regression analysis using factors other than ba-PWV and respiratory function as adjustment variables, both FVC%pred and FEV1%pred showed significant negative relationships with ba-PWV (P<0.05).ConclusionsThe results indicate that FEV1/FVC, an indicator of airflow limitation, is not a predictor of ba-PWV. However, since ba-PWV showed significant negative relationship with FVC%pred and FEV1%pred, clinically assessment of arterial stiffness might be considered in individuals with impaired pulmonary ventilation.