VENTILATION-PERFUSION MISMATCHING AS PROGNOSTIC FACTOR OF RESPIRATORY-FAILURE AFTER PULMONARY RESECTION

This paper reports the results of a retrospective study undertaken to assess the reliability of regional ventilation-perfusion pulmonary sca nning in predicting the remaining respiratory function (pFEV(1)), and the early and long-term outcome of 33 patients with chronic airways di sease, submitted to pulmonary resection at the Ist Department of Surge ry, All patients had been diagnosed as resectable with the traditional tools and had had a traditional pFEV(1) (tpFEV(1)) greater than 800 m i, All pFEV(1) were re-calculated (npFEV(1)) with our new formula whic h also includes as lost for function all lung areas not to be resected with V/Q mismatching, Normal perfusion and ventilation distribution w as found in 24.2% of patients in the lesion area and in 33.3% in the r emaining pulmonary areas, An impairment of perfusion was observed in t he lesion area in 72.7% of patients, in the remaining areas in 48.4%, An impairment of ventilation was observed in the same regions in 66.6% and 48.5% of patients, respectively, Abnormality in ventilation/perfu sion matching occurred in the lesion area in 15.2% of cases, in the ip silateral lung areas in 18.2%, in the contralateral lung in 48.4% of c ases, In predicting postoperative FEV(1), and early and long-term mort ality among our resectable patients, the tpFEV(1) showed an accuracy o f 91%, an index of resectability of 93.7%, of unresectability of 0%, O ur npFEV(1) reached an accuracy of 94.4%, an index of resectability of 100% and an index of unresectability of 66.7%.