A loss of forced expiratory volume in one second (FEV1) may be a clinical indicator of postoperative pneumonia development in patients following an anatomic lung resection, according to a study published in the Annals of Thoracic Surgery.
Researchers identified 384 patients who received either an open or minimally invasive lung resection and prospectively evaluated them postoperatively to identify a possible correlation between postoperative spirometry values and pulmonary complications.
Results indicated that there was a significantly higher incidence of postoperative pneumonia in patients who underwent open vs minimally invasive lung resection (13.2% vs 4.4%; P =.016). In addition, patients on postoperative day 4 who experienced a significant reduction in FEV1 compared with baseline were found to have developed postoperative pneumonia compared with patients without pneumonia (43% vs 32.2%; P =.013).
The diagnostic threshold was set at a loss of 40% or more of FEV1 from a preoperative absolute on postoperative day 4, which would have correctly identified 88.9% of patients in the study diagnosed with postoperative pneumonia.
The investigators concluded that “daily bedside spirometry might be a helpful diagnostic adjunct for early recognition, and hence, timely treatment, of pulmonary infection after open anatomic lung resections.”
Kocher GJ, Gioutsos KP, Ahler M, et al. Perioperative lung function monitoring for anatomic lung resections [published online September 27, 2017]. Ann Thorac Surg. doi:10.1016/j.athoracsur2017.06.018