Pulmonary complications following major lung resection for benign and malignant lung diseases

To assess the incidence and to identify the possible associated risk factors for postoperative pulmonary complications after major lung resection. One hundred and sixty-eight consecutive patients undergoing major lung resection for benign and malignant lung disease over a 3-year period were included in the study. Preoperative assessment clinical parameters, intraoperative and postoperative events were recorded. Pulmonary complications were noted according to a precise definition. The risk of complications associated with age, comorbidity, forced vital capacity [FVC], blood transfusion and extended operation was evaluated using logistic regression analysis. The mean age of the patients was 47.1 years [range 16-80 years], 137 [77%] patients underwent lobectomy, 23 [14%] pneumonectomy, and 15 [9%] bilobectomy. Forty-six [27%] patients developed postoperative pulmonary complications and 2 [1.1%] died within 30 days following the operation. Age =/>65 years [OR 3.7, 95% CI: 1.5-8.6, p = 0.002], the presence of comorbid cardiopulmonary disease [OR 0.2, 95% CI: 0.1-0.5, p = 0.001], FVC <50% [OR 0.2, 95% CI: 0.1-0.8, p = 0.02], blood transfusion [OR 0.2, 95% CI: 0.1-0.4, p = 0.0001], and extended operation [OR 0.2, 95% CI: 0.07-0.6, p = 0.005] were the identified factors associated with the development of postoperative pulmonary complications, which necessitated an increased length of hospital stay. Postoperative pulmonary complications are more likely to develop in patients with age =/>65 years with comorbid cardiopulmonary disease, FVC <50%, blood transfusion, and extended operation

Risk factors of spontaneous pneumothorax in Kuwait

To determine the risk factors of spontaneous pneumothorax [SP] in Kuwait. From January 2002 through December 2003, 254 consecutive cases with a diagnosis of SP were reviewed. Analyses of pneumothorax rates by age, sex, smoking, body mass index [BMI] and climatic conditions were evaluated. Of the 254 patients, 242 [95%] were male and 12 [5%] were female; a larger proportion of 180 [88%] were Kuwaitis and 74 [12%] were expatriates. Two hundred and eight [82%] episodes were regarded as primary SP and 46 [18%] as secondary SP. The mean age was 24.5 +/- 5.8 years for primary SP and 45.7 +/- 14.5 years for secondary SP. One hundred and ninety-six [77%] individuals were current smokers. BMI in primary and secondary SP was 19.3 and 22.4, respectively [p < 0.001]. There was no relationship between SP and climatic conditions [a rise or fall in temperature, humidity or atmospheric pressure]. However, a slight increase in SP occurred in July, probably the hottest month in Kuwait. The data indicate that the most important risk factors of SP in Kuwait are smoking, low BMI and the male gender

Pulmonary arteriovenous malformation presenting with severe hypoxemia

To report a case of right pulmonary arteriovenous malformation [PAVM] affecting the right upper lobe, following the incidence of empyema thoracis in the contralateral lung. A 19-year-old, previously healthy male presented with acute respiratory distress, left pleuritic chest pain, fever and hypoxemia. Clinical findings, laboratory and radiological examinations including pulmonary angiogram were consistent with the diagnosis of left pneumonia complicated with parapneumonic pleura! effusion and right upper lobe PAVM. The patient was intubated and ventilated because of persistent hypoxemia. He was successfully treated by percutaneous transcatheter embolization. This case shows that percutaneous transcatheter embolization is a safe and effective first option for the treatment of PAVM