Incidence and Risk Factors of Postpneumonectomy Pulmonary Edema with Non-Small Cell Lung Cancer: A Retrospective Analysis

ABSTRACT

PURPOSE: To evaluate the incidence of postpneumonectomy pulmonary edema (PPE) and determine the risk factors for PPE with non-small cell lung caner. MATERIALS AND METHODS: A group of 93 patients who underwent a pneumonectomy between 1994 and 2004 were retrospectively studied. Postpneumonectomy patients with pulmonary edema, with no clinically evident cause, with the exception of having undergone a pneumonectomy, were considered to have PPE. The incidence and mortality of PPE were recorded. The preoperative, perioperative and postoperative clinical data were reviewed, and the patients matched for known or suspected risk factors for PPE. A logistic regression analysis and Chi-square test were used to evaluate the relationships of the risk factors to the PPE. RESULTS: The incidence of PPE was 7.5% (n=7). The mortality in the group of patients who developed PPE was 86% (n=6). Patients who had fresh frozen plasma administered had a significantly higher incidence of PPE (risk ratio=14.9, p=0.024). CONCLUSION: Fresh frozen plasma (FFP) transfusion after a pneumonectomy was shown to be an important risk factor in our data. The mechanism has not been identified, but may be an increased capillary permeability of the pulmonary vessels due to an immunologic reaction following a FFP transfusion