Document Detail


Intraoperative solumedrol helps prevent postpneumonectomy pulmonary edema.
MedLine Citation:
PMID:  14529979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Postpneumonectomy pulmonary edema and pneumonia are life threatening and seemingly unavoidable complications after pneumonectomy. We theorized that an intraoperative dose of intravenous steroids (as a prophylactic measure to reduce pulmonary injury to the remaining lung) just before pulmonary artery ligation might decrease this problem. METHODS: Seventy-two patients (52 men) who had pneumonectomy during two time periods were studied prospectively. Thirty-five patients received 250 mg of methylprednisolone sodium succinate (Solumedrol; Upjohn, Kalamazoo, MI) just before pulmonary artery ligation (S group) and 37 did not (non-S group). Groups were matched for known or suspected preoperative, intraoperative, and postoperative risk factors for postpneumonectomy pulmonary edema. RESULTS: The incidence of postpneumonectomy pulmonary edema or adult respiratory distress syndrome was less in the S group (0 of 35, 0% versus 5 of 37, 13.5%, p = 0.049), the overall major complication rate was less in the S group (7 of 35, 20% versus 16 of 37, 43%, p = 0.04), and the length of hospital stay was shorter in the S group (6.1 days versus 11.9 days, p = 0.02). In addition, there were no bronchopleural fistulas in the S group compared with two (both right-sided) in the non-S group. CONCLUSIONS: The intraoperative intravenous administration of 250 mg of methylprednisolone sodium succinate just before pulmonary artery ligation during pneumonectomy may reduce the incidence of postpneumonectomy pulmonary edema and adult respiratory distress syndrome as well as decrease other major complications and shorten the hospital stay. It does not seem to increase the incidence of bronchopleural fistula. Further randomized trials are needed.
Authors:
Robert J Cerfolio; Ayesha S Bryant; John S Thurber; Cynthia Sales Bass; William A Lell; Alfred A Bartolucci
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  76     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-07     Completed Date:  2003-11-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1029-33; discussion 1033-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. robert.cerfolio@ccc.uab.edu
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / administration & dosage,  therapeutic use*
Bronchial Fistula / etiology
Female
Humans
Injections, Intravenous
Intraoperative Period
Length of Stay
Male
Methylprednisolone Hemisuccinate / administration & dosage,  therapeutic use*
Middle Aged
Pleural Diseases / etiology
Pneumonectomy*
Postoperative Complications / prevention & control
Prospective Studies
Pulmonary Edema / prevention & control*
Respiratory Distress Syndrome, Adult / prevention & control
Respiratory Tract Fistula
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 2921-57-5/Methylprednisolone Hemisuccinate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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