POSTPNEUMONECTOMY PULMONARY-EDEMA - A RETROSPECTIVE ANALYSIS OF INCIDENCE AND POSSIBLE RISK-FACTORS

Objective: To analyze the incidence of postpneumonectomy pulmonary ede ma (PPE) and to determine potential risk factors for PPE. Material and methods: A group of 197 patients was studied retrospectively, and the incidence of PPE tvas recorded over a 5-year period, Preoperative, pe rioperative, and postoperative clinical data were collected, and preop erative and postoperative chest radiographs were reviewed, A scoring s ystem was used to distinguish between premanifest and manifest PPE, Po stpneumonectomy patients with pulmonary edema, with no clinically evid ent cause, were considered to have PPE, Results: The incidence of prem anifest PPE was 12.2% (n=24), and that of manifest PPE was 2.5% (n=5). Mortality in the group of patients who developed manifest PPE was 100 %, Two significant perioperative associations were found in the PPE gr oup. One was the administration of fresh frozen plasma (FFP) transfusi ons (relative risk, 4.3; 95% confidence interval, 1.3 to 14.4 correcte d for age and sex), while the other was higher mechanical ventilation pressures during surgery (relative risk, 3.0; 95% confidence interval, 1.2 to 7.3), Conclusion: Our data suggest that FFP transfusions form an important risk factor for PPE, The mechanism may be an increased pe rmeability of the pulmonary vessels due to an immunologic reaction aft er multiple FFP transfusions. The significantly higher mechanical vent ilation pressures we found ire the PPE group may be explained as an ea rly sign of the development of PPE.