PULMONARY VENTILATION AND GAS EXCHANGE EFFICIENCY IN RISK ASSESSMENT FOR CHRONIC POSTTHROMBOEMBOLIC PULMONARY HYPERTENSION

Abstract

Aim. To evaluate prognostic significance of diffusion capacity of the lungs and efficacy of pulmonary gas exchange in risk assessment of perioperational and early postoperational complications in patients with chronic post-thromboembolic pulmonary hypertension (CPH).Material and methods. Totally, 131 patient included, with CPH, who had undergone thrombo-endarterectomy from the branches of pulmonary artery. Before the surgery, together with standard investigation, the following methods were applied: body pletismography, lung diffusion capacity assessment, ventilation efficiency assessment. The relation was analyzed, of the parameters of pulmonary functional tests with the results of surgical treatment of CPH patients.Results. CPH patients present with a low level of pulmonary diffusion capacity and ventilation efficiency. Among the parameters of pulmonary functional tests, diffusion ability of the lungs shows the highest prediction significance in surgical risk assessment for CPH treatment. The relation found, for diffusion ability of the lungs and risk of respiratory failure (ОR 0,94 (0,91-0,99), p=0,004), heart failure (ОR 0,93 (0,87-1,00), p=0,023), short term post-operaton mortality (ОR 0,95 (0,89-0,99), p=0,034) and long-term mortality (ОR 0,94 (0,79-0,99), p=0,030). Efficacy of pulmonary ventilation showed significant relation only with the development of respiratory failure (ОR 0,91 (0,82-1,00), p=0,038)Conclusion. Decline of pulmonary diffusion ability to 45% and lower from expected level increases the risk of respiratory and heart failure development in early postoperation period, as the risk of in-hospital death and mortality throughout 1 year follow-up after thrombo-endarterectomy from the branches of pulmonary artery.

Keywords

• chronic thromboembolic pulmonary hypertension
• diffusion ability of the lungs
• lung function tests