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Patient and Surgical Factors Influencing Air Leak After Lung Volume Reduction Surgery: Lessons Learned From the National Emphysema Treatment Trial  Malcolm.

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Presentation on theme: "Patient and Surgical Factors Influencing Air Leak After Lung Volume Reduction Surgery: Lessons Learned From the National Emphysema Treatment Trial  Malcolm."— Presentation transcript:

1 Patient and Surgical Factors Influencing Air Leak After Lung Volume Reduction Surgery: Lessons Learned From the National Emphysema Treatment Trial  Malcolm M. DeCamp, MD, Eugene H. Blackstone, MD, Keith S. Naunheim, MD, Mark J. Krasna, MD, Douglas E. Wood, MD, PhD, Yvonne M. Meli, RN, Robert J. McKenna, MD  The Annals of Thoracic Surgery  Volume 82, Issue 1, Pages (July 2006) DOI: /j.athoracsur Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Among patients experiencing air leaks after closure at any time during the first 30 days after lung volume reduction surgery, the number that stopped on each day. Air leak persisting at least 30 days is shown in the extreme right-hand bar. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Relation of patient, disease management, pulmonary function, and disease factors to duration of air leak among patients in whom air leak occurred within 30 days of lung volume reduction surgery. Step graphs represent Kaplan-Meier survival-type estimates because data were censored at 30 days and at death (if air leak persisted until that time) within 30 days. Vertical bars represent asymmetric 68% confidence limits equivalent to ±1 standard error. Numbers in parentheses are number remaining with air leak at that interval. A higher line indicates more prolonged air leak, a lower line shorter air leak. (A) Caucasian (□, n = 469) versus other ethnicities (○, n = 24). (B) Use of inhaled steroids (□, n = 350) versus no inhaled steroids (○, n = 143). (C) Diffusing capacity (percent of predicted; ○ ≤ 20, n = 119; □ = 20 to 30, n = 197; ▵ = 30 to 40, n = 126; ♢ > 40, n = 51). Number of patients remaining with air leaks at various time points is not shown because of busyness of the figure. (D) One-second forced expiratory volume (FEV1, percent of predicted; ○ = ≤20, n = 103; □ = 20 to 30, n = 239; ▵ = >30; n = 151). (E) Distribution of disease, lower lobe (□, n = 59) versus other (○, n = 359). (F) Presence (□, n = 213) or absence (○, n = 279) of moderate or severe pleural adhesions. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Postoperative length of stay in 54 pairs of propensity-matched patients who either did (□) or did not (○) experience air leak in the 30 days after lung volume reduction surgery. Depiction is as in Fig 2. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions


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