Negative-pressure Pulmonary Edema And Hemorrhage Associated With Upper Airway Obstruction [edema E Hemorragia Pulmonar Por Pressão Negativa Associados à Obstrução Das Vias Aéreas Superiores]

Negative-pressure pulmonary edema accompanied by hemorrhage as a manifestation of upper airway obstruction is an uncommon problem that is potentially life-threatening. The principal pathophysiological mechanism involved is the generation of markedly negative intrathoracic pressure, which leads to an increase in pulmonary vascular volume and pulmonary capillary transmural pressure, creating a risk of disruption of the alveolar-capillary membrane. We report the case of an adult male with diffuse alveolar hemorrhage following acute upper airway obstruction caused by the formation of a cervical and mediastinal abscess resulting from the insertion of a metallic tracheal stent. The patient was treated through drainage of the abscess, antibiotic therapy, and positive pressure mechanical ventilation. This article emphasizes the importance of including this entity in the differential diagnosis of acute lung injury after procedures involving upper airway instrumentation.346420424Koh, M.S., Hsu, A.A., Eng, P., Negative pressure pulmonary oedema in the medical intensive care unit (2003) Intensive Care Med, 29 (9), pp. 1601-1604Bhavani-Shankar, K., Hart, N.S., Mushlin, P.S., Negative pressure induced airway and pulmonary injury (1997) Can J Anaesth, 44 (1), pp. 78-81Schwartz, D.R., Maroo, A., Malhotra, A., Kesselman, H., Negative pressure pulmonary hemorrhage (1999) Chest, 115 (4), pp. 1194-1197Van Kooy, M.A., Gargiulo, R.F., Postobstructive pulmonary edema (2000) Am Fam Physician, 62 (2), pp. 401-404Pavlin, D.J., Nessly, M.L., Cheney, F.W., Increased pulmonary vascular permeability as a cause of re-expansion edema in rabbits (1981) Am Rev Respir Dis, 124 (4), pp. 422-427Willms, D., Shure, D., Pulmonary edema due to upper airway obstruction in adults (1988) Chest, 94 (5), pp. 1090-1092Guffin, T.N., Har-el, G., Sanders, A., Lucente, F.E., Nash, M., Acute postobstructive pulmonary edema (1995) Otolaryngol Head Neck Surg, 112 (2), pp. 235-237McGowan, F.X., Kenna, M.A., Fleming, J.A., O'Connor, T., Adenotonsillectomy for upper airway obstruction carries increased risk in children with a history of prematurity (1992) Pediatr Pulmonol, 13 (4), pp. 222-226Ikeda, H., Asato, R., Chin, K., Kojima, T., Tanaka, S., Omori, K., Negative-pressure pulmonary edema after resection of mediastinum thyroid goiter (2006) Acta Otolaryngol, 126 (8), pp. 886-888West, J.B., Mathieu-Costello, O., Stress failure of pulmonary capillaries: Role in lung and heart disease (1992) Lancet, 340 (8822), pp. 762-767Rocker, G.M., Mackenzie, M.G., Williams, B., Logan, P.M., Noninvasive positive pressure ventilation: Successful outcome in patients with acute lung injury/ARDS (1999) Chest, 115 (1), pp. 173-177Butterell, H., Riley, R.H., Life-threatening pulmonary oedema secondary to tracheal compression (2002) Anaesth Intensive Care, 30 (6), pp. 804-806Antonelli, M., Conti, G., Moro, M.L., Esquinas, A., Gonzalez-Diaz, G., Confalonieri, M., Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: A multi-center study (2001) Intensive Care Med, 27 (11), pp. 1718-1728Adolph, M.D., Oliver, A.M., Dejak, T., Death from adult respiratory distress syndrome and multiorgan failure following acute upper airway obstruction (1994) Ear Nose Throat J, 73 (5), pp. 324-327Westreich, R., Sampson, I., Shaari, C.M., Lawson, W., Negative-pressure pulmonary edema after routine septorhinoplasty: Discussion of pathophysiology, treatment, and prevention (2006) Arch Facial Plast Surg, 8 (1), pp. 8-15Ackland, G.L., Mythen, M.G., Negative pressure pulmonary edema as an unsuspected imitator of acute lung injury/ARDS (2005) Chest, 127 (5), pp. 1867-186

The influence of clamp usage on clot deposit formation inside thoracic drains

Background: A prospective study was done to evaluate the influence of clamp usage on clot formation inside thoracic drains. Methods: Each drain was weighed soon after removal; they were then washed, dried and weighed again. The difference between the first andsecondw eights was taken as the amount of clot deposit formed. Results: We found more clots accumulated inside the drains that were temporarily obstructed by the clamp. Conclusion: In this study, there were more clots formation inside thoracic drains clamped, even if they were occluded intermottently. This can lead thoracic drains to function improperly. The discussion about the correct usage of thoracic drains must he a subject for educational programs for physicians and nurses, to aim for the safest use of this widely used and highly efficient system.Conduziu-se este estudo prospectivo a fim de avaliar-se a influência do uso da braçadeira sobre o acúmulo de coágulos dentro dos drenos pleurais. Os drenos pleurais foram pesados logo após sua retirada, lavados e secados e pesados novamente. A diferença entre a primeira e a segunda pesagem foi admitida como a quantidade de coágulos acumulada. Houve maior acúmulo de coágulo nos drenos temporariamente obstruídos por braçadeira em relação àqueles não obstruídos. Notou-se, neste estudo, maior acúmulo de coágulo dentro de drenos pleurais obstruídos, mesmo que intermitentemente, o que pode levar ao mau funcionamento de todo o sistema de drenagem. A discussão sobre o correto uso dos drenos pleurais deve ser constante e fazer parte de programas de educação continuada para médicos e enfermagem, a fim de que este sistema, amplamente utilizado e altamente eficiente, seja otimizado3527982Lima, A.G., Toro, I.F.C., Tincani, A.J., Barreto, G., A drenagem pleural pré-hospitalar: Apresentação de mecanismo de válvula unidirecional. (2006) Rev Col Bras Cir, 33 (2), pp. 101-106Barton, E.D., Epperson, M., Hoyt, D.B., Fortlage, D., Rosen, P., Prehospital needle aspiration and tube thoracostomy in trauma victims: A six-year experience with aeromedical crews (1995) J Emerg Med, 13 (2), pp. 155-163Hyde, J., Sykes, T., Graham, T., Reducing morbidity from chest drains (1997) BMJ, 314 (7085), pp. 914-915McMahon-Parkes, K., Management of pleural drains (1997) Nurs Times, 93 (52), pp. 48-49Wagner, R.B., Slivko, B., Highlights of the history of nonpenetranting chest trauma (1989) Surg Clin North Am, 69 (1), pp. 1-14Baumann, M.H., What size chest tube? What drainage system is ideal? And other chest tube management questions (2003) Curr Opin Pulm Med, 9 (4), pp. 276-281Harris, D.R., Graham, T.R., Management of intercostal drains (1991) Br J Hosp Med, 45 (6), pp. 383-386Graham, A.N., Cosgrove, A.P., Gibbons, J.R.P., McGuigan, J.A., Randomised clinical trial of chest drainage systems (1992) Thorax, 47 (6), pp. 461-462Symbas, P.N., Chest drainage valve (1978) Emerg Med Serv, 7 (3), pp. 41-46Munnell, E.R., Thoracic drainage (1997) Ann Thorac Surg, 63 (5), pp. 1497-1502Coughlin, A.M., Parchinsky, C., Go with the flow of chest tube therapy (2006) Nursing, 36 (3), pp. 36-41Shuster, P.M., Chest tubes: To clamp or not to clamp (1998) Nurs Educ, 23 (3), pp. 9-13Tooley, C., The management and care of chest drains (2002) Nurs Times Plus, 98 (26), pp. 49-50Bar-El, Y., Ross, A., Kablawi, A., Egenburg, S., Potentially dangerous negative intrapleural pressures generated by ordinary pleural drainage systems (2001) Chest, 119 (2), pp. 511-514Smith, R.N., Fallentine, J., Kessel, S., Underwater chest drainage: Bringing the facts to the surface (1995) Nursing, 25 (2), pp. 60-63Younes, R.N., Gross, J.L., Aguiar, S., Haddad, F.J., Deheinzelin, D., When to remove a chest tube? A randomised study with subsequent prospective consecutive validation (2002) J Am Coll Surg, 195 (5), pp. 658-662Gambazzi, F., Schirren, J., Thoraxdrainagen, Was its "evidence based"? (2003) Chirurg, 74 (2), pp. 99-107Wallen, M., Morrison, A., Gillies, D., O'Riordan, E., Brigde, C., Stoddart, F., Mediastinal chest drain clearance for cardiac surgery (2006) The Cochrane Library, Issue, 1Tattersall, D.J., Traill, Z.C., Gleeson, F.V., Chest drains: Does size matter? (2000) Clin Radiol, 55 (6), pp. 415-421A prospective study was done to evaluate the influence of clamp usage on clot formation inside thoracic drains. Methods: Each drain was weighed soon after removal; they were then washed, dried and weighed again. The difference between the first andsecondw eights was taken as the amount of clot deposit formed. Results: We found more clots accumulated inside the drains that were temporarily obstructed by the clamp. Conclusion: In this study, there were more clots formation inside thoracic drains clamped, even if they were occluded intermottently. This can lead thoracic drains to function improperly. The discussion about the correct usage of thoracic drains must he a subject for educational programs for physicians and nurses, to aim for the safest use of this widely used and highly efficient syste

Standardization Of A Method Of Prolonged Thoracic Surgery And Mechanical Ventilation In Rats To Evaluate Local And Systemic Inflammation

Purpose: To evaluate the immediate pulmonary and systemic inflammatory response after a long-term operative period. Methods: Wistar rats in the experimental group were anaesthetized and submitted to tracheostomy, thoracotomy and remained on mechanical ventilation during three hours. Control animals were not submitted to the operative protocol. The following parameters have been evaluated: pulmonary myeloperoxidase activity, pulmonary serum protein extravasation, lung wet/dry weight ratio and measurement of levels of cytokines in serum. Results: Operated animals exhibited significantly lower serum protein extravasation in lungs compared with control animals. The lung wet/dry weight ratio and myeloperoxidase activity did not differ between groups. Serum cytokines IL-1β, TNF-α, and IL-10 levels were not detected in groups, whereas IL-6 was detected only in operated animals. Conclusion: The experimental mechanical ventilation in rats with a prolonged surgical time did not produce significant local and systemic inflammatory changes and permit to evaluate others procedures in thoracic surgery.2613843Gothard, J., Lung injury after thoracic and one-lung ventilation (2006) Curr Opin Anaesthesiol, 19 (1), pp. 5-10Matute-Bello, G., Frevert, C.W., Martin, T.R., Animal models of acute lung injury (2008) Am J Physiol Cell Mol Physiol, 295 (3), pp. L379-99Braeuninger, S., Kleinschnitz, C., Rodent models of focal ischemia: Procedural pitfalls and translational problems (2009) Exp Transl Stroke Med, 25, pp. 1-8Brain, S.D., Williams, T.J., Inflammatory oedema induced by synergism between calcitonin gene-related peptide (CGRP) and mediators of increased vascular permeability (1985) Br J Pharmacol, 86, pp. 855-860Bradley, P.P., Priebat, D.A., Christensen, R.D., Rothstein, G., Measurement of cutaneous inflammation: Estimation of neutrophil content with an enzyme marker (1982) J Invest Dermatol, 78 (3), pp. 206-209Chang, K.P., Huang, S.H., Lin, C.L., Chang, L.L., Lin, S.D., Lai, C.S., An alternative model of composite tissue allotransplantation: Groin-thigh flap (2008) Transpl Int, 21 (6), pp. 564-571Unzueta, M.C., Casas, J.I., Moral, M.V., Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for thoracic surgery (2007) Anesth Analg, 104 (5), pp. 1029-1033Tanaka, S., Tsuchida, H., Nakabayashi, K.-I., Seki, S., Namiki, A., The effects of sevoflurane, isoflurane, halothane, and enflurane on hemodynamic responses during an inhaled induction of anesthesia via a mask in humans (1996) Anesthesia and Analgesia, 82 (4), pp. 821-826. , DOI 10.1097/00000539-199604000-00025Liu, R., Ishibe, Y., Ueda, M., Isoflurane-sevoflurane administration before ischemia attenuates ischemia-reperfusion-induced injury in isolated rat lungs (2000) Anesthesiology, 92 (3), pp. 833-840Lima, R.C., Escobar, M.A.S., Diniz, R., D'Aconda, G., Bergsland, J., Salermo, T., Avaliação hemodinâmica intra-operatória na cirurgia de revascularização do miocárdio sem o auxílio de circulação extracorpórea (2000) Rev Bras Circ Cardiovasc, 15 (3), pp. 201-211Basagan-Mogol, E., Goren, S., Korfali, G., Turker, G., Kaya, F.N., Induction of anesthesia in coronary artery bypass graft surgery: The hemodynamic and analgesic effects of ketamine (2010) Clinics, 65 (2), pp. 133-138Fuentes, J.M., Hanly, E.J., Bachman, S.L., Aurora, A.R., Marohn, M.R., Talamini, M.A., Videoendoscopic endotracheal intubation in the rat: A comprehensive rodent model of laparoscopic surgery (2004) J Surg Res, 122 (2), pp. 240-248Lawrence, T., Wlloughby, D.A., Gilroy, D.W., Anti-inflammatory lipid mediators and insights into the resolution of inflammation (2002) Nat Rev Immunol, 2 (10), pp. 787-795Lewis, C.A., Martin, G.S., Understanding and managing fluid balance in patients with acute lung injury (2004) Curr Opin Crit Care, 10 (1), pp. 13-17Soni, N., Willians, P., Positive pressure ventilation: What is the real cost? (2008) Br J Anaesth, 101 (4), pp. 446-457Schumann, S., Kirschbaum, A., Schliessmann, S.J., Wagner, G., Goebel, U., Priebe, H.J., Guttmann, J., Low pulmonary artery flush perfusion pressure combined with high positive end-expiratory pressure reduces oedema formation in isolated porcine lungs (2010) Physiol Meas, 31 (2), pp. 261-272Soehnlein, O., Weber, C., Lindbom, L., Neutrophil granule proteins tune monocytic cell function (2009) Trends Immunol, 30 (11), pp. 538-546Grattendick, K., Stuart, R., Roberts, E., Lincoln, J., Lefkowitz, S.S., Bollen, A., Moguilevsky, N., Lefkowitz, D.L., Alveolar macrophage activation by myeloperoxidase: A model for exacerbation of lung inflammation (2002) American Journal of Respiratory Cell and Molecular Biology, 26 (6), pp. 716-722Ferreira, A.L.A., Matsubara, L.S., Radicais livres: Conceitos, doenças relacionadas, sistema de defesa e estresse oxidativo (1997) Rev Assoc Med Bras, 43 (1), pp. 61-68Morrison, D.F., Foss, D.L., Murtaugh, M.P., Interleukin-10 gene therapy-mediated amelioration of bacterial pneumonia (2000) Infect Immun, 68 (8), pp. 4752-475

Descriptive analysis of and overall survival after surgical treatment of lung metastases

To describe demographic characteristics, surgical results, postoperative complications, and overall survival rates in surgically treated patients with lung metastases. Methods: This was a retrospective analysis of 119 patients who underwent a total of 154 lung metastasis resections between 1997 and 2011. Results: Among the 119 patients, 68 (57.1%) were male and 108 (90.8%) were White. The median age was 52 years (range, 15-75 years). In this sample, 63 patients (52.9%) presented with comorbidities, the most common being systemic arterial hypertension (69.8%) and diabetes (19.0%). Primary colorectal tumors (47.9%) and musculoskeletal tumors (21.8%) were the main sites of origin of the metastases. Approximately 24% of the patients underwent more than one resection of the lesions, and 71% had adjuvant treatment prior to metastasectomy. The rate of lung metastasis recurrence was 19.3%, and the median disease-free interval was 23 months. The main surgical access used was thoracotomy (78%), and the most common approach was wedge resection with segmentectomy (51%). The rate of postoperative complications was 22%, and perioperative mortality was 1.9%. The overall survival rates at 12, 36, 60, and 120 months were 96%, 77%, 56%, and 39%, respectively. A Cox analysis confirmed that complications within the first 30 postoperative days were associated with poor prognosis (hazard ratio = 1.81; 95% Cl: 1.09-3.06; p = 0.02). Conclusions: Surgical treatment of lung metastases is safe and effective, with good overall survival, especially in patients with fewer metastases396650658Descrever características demográficas, resultados operatórios, complicações pós-operatórias e taxa de sobrevida global em pacientes com metástases pulmonares tratados cirurgicamente. Análise retrospectiva de 119 pacientes submetidos a um total de 154 cirurgias de ressecção de metástase pulmonar entre 1997 e 2011. Resultados: Do total de 119 pacientes, 68 (57,1%) eram do sexo masculino, e 108 (90,8%) eram brancos. A mediana de idade foi de 52 anos (variação, 15-75 anos). Nessa amostra, 63 pacientes (52,9%) apresentaram comorbidades, sendo as mais frequentes hipertensão arterial sistêmica (69,8%) e diabetes (19,0%). Tumores primários colorretais (47,9%) e musculoesqueléticos (21,8%) foram os principais sítios de origem das metástases. Aproximadamente 24% dos pacientes foram submetidos a mais de uma ressecção das lesões, e 71% fizeram tratamento adjuvante prévio à metastasectomia. A taxa de recidiva de metástase pulmonar foi de 19,3%. A mediana do intervalo livre de doença foi de 23 meses. A principal via de acesso usada foi toracotomia (78%), e o tipo de ressecção mais frequente foi em cunha e segmentectomia (51%). O índice de complicações pós-operatórias foi de 22% e o de mortalidade perioperatória foi de 1,9%. As taxas de sobrevida global em 12, 36, 60 e 120 meses foram, respectivamente, de 96%, 77%, 56% e 39%. A análise de Cox confirmou que complicações nos primeiros 30 dias pós-operatórios associaram-se a pior prognóstico (hazard ratio = 1,81; IC95%: 1,09-3,06; p = 0,02). Conclusões: O tratamento cirúrgico das metástases pulmonares oriundas de diferentes sítios tumorais é efetivo e seguro, com boa sobrevida global, especialmente nos casos com um menor número de lesões pulmonare

Descriptive Analysis Of And Overall Survival After Surgical Treatment Of Lung Metastases [análise Descritiva E Sobrevida Global Do Tratamento Cirúrgico Das Metástases Pulmonares]

Objective: To describe demographic characteristics, surgical results, postoperative complications, and overall survival rates in surgically treated patients with lung metastases. Methods: This was a retrospective analysis of 119 patients who underwent a total of 154 lung metastasis resections between 1997 and 2011. Results: Among the 119 patients, 68 (57.1%) were male and 108 (90.8%) were White. The median age was 52 years (range, 15-75 years). In this sample, 63 patients (52.9%) presented with comorbidities, the most common being systemic arterial hypertension (69.8%) and diabetes (19.0%). Primary colorectal tumors (47.9%) and musculoskeletal tumors (21.8%) were the main sites of origin of the metastases. Approximately 24% of the patients underwent more than one resection of the lesions, and 71% had adjuvant treatment prior to metastasectomy. The rate of lung metastasis recurrence was 19.3%, and the median disease-free interval was 23 months. The main surgical access used was thoracotomy (78%), and the most common approach was wedge resection with segmentectomy (51%). The rate of postoperative complications was 22%, and perioperative mortality was 1.9%. The overall survival rates at 12, 36, 60, and 120 months were 96%, 77%, 56%, and 39%, respectively. A Cox analysis confirmed that complications within the first 30 postoperative days were associated with poor prognosis (hazard ratio = 1.81; 95% CI: 1.09-3.06; p = 0.02). Conclusions: Surgical treatment of lung metastases is safe and effective, with good overall survival, especially in patients with fewer metastases.396650658Aberg, T., Malmberg, K.A., Nilsson, B., Nöu, E., The effect of metastasectomy: Fact or fiction? (1980) Ann Thorac Surg., 30 (4), pp. 378-384. , http://dx.doi.org/10.1016/S0003-4975(10)61278-7Weinlechner, J.D., Tumorenan der brustwand und derenbehand-lung (Resektion der rippen, eroffnung der brusthohle, partielleentfernun der lunge) (1882) Wiener Med Wschr., 20, pp. 589-591Ehrenhaft, J.L., Pulmonary resections for metastatic lesions (1951) AMA Arch Surg., 63 (3), pp. 326-336. , http://dx.doi.org/10.1001/archsurg.1951.01250040332007, PMid:14868186Fujisawa, T., Yamaguchi, Y., Saitoh, Y., Sekine, Y., Iizasa, T., Mitsunaga, S., Factors influencing survival following pulmonary resection for metastatic colorectal carcinoma (1996) Tohoku J Exp Med., 180 (2), pp. 153-160. , http://dx.doi.org/10.1620/tjem.180.153, PMid:9111764Dellai, R.C.A., Chojniak, R., Marques, E., Younes, R.N., Detecção de nódulos pulmonares por tomografia computadorizada em pacientes com metástases pulmonares submetidos à cirurgia (1994) J Pneumol., 20 (SUPPL. 3), p. 28Thomford, N.R., Woolner, L.B., Clagett, O.T., The surgical treatment of metastatic tumors in the lungs (1965) J Thorac Cardiovasc Surg., 49, pp. 357-363. , PMid:14265951Morales-Blanhir, J.E., Palafox Vidal, C.D., Rosas Romero Mde, J., García Castro, M.M., Londono Villegas, A., Zamboni, M., Six-minute walk test: A valuable tool for assessing pulmonary impairment (2011) J Bras Pneumol., 37 (1), pp. 110-117. , http://dx.doi.org/10.1590/S1806-37132011000100016, PMid:21390439Younes, R.N., Haddad, F., Ferreira, F., Gross, J.L., Surgical removal of pulmonary metastasis: Prospective study in 182 patients [Article in Portuguese] (1998) Rev Assoc Med Bras., 44 (3), pp. 218-225. , PMid:9755551Moore, K.H., McCaughan, B.C., Surgical resection for pulmonary metastases from colorectal cancer (2001) ANZ J Surg., 71 (3), pp. 143-146. , http://dx.doi.org/10.1046/j.1440-1622.2001.02057.xPfannschmidt, J., Muley, T., Hoffmann, H., Dienemann, H., Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: Experiences in 167 patients (2003) J Thorac Cardiovasc Surg., 126 (3), pp. 732-739. , http://dx.doi.org/10.1016/S0022-5223(03)00587-7Rena, O., Casadio, C., Viano, F., Cristofori, R., Ruffini, E., Filosso, P.L., Pulmonary resection for metastases from colorectal cancer: Factors influencing prognosis. Twenty-year experience (2002) Eur J Cardiothorac Surg., 21 (5), pp. 906-912. , http://dx.doi.org/10.1016/S1010-7940(02)00088-XSaito, Y., Omiya, H., Kohno, K., Kobayashi, T., Itoi, K., Teramachi, M., Pulmonary metastasectomy for 165 patients with colorectal carcinoma: A prognostic assessment (2002) J Thorac Cardiovasc Surg., 124 (5), pp. 1007-1013. , http://dx.doi.org/10.1067/mtc.2002.125165, PMid:12407386Toscano, E., (1991) Tratamento cirúrgico das metástases nodulares do pulmão, , [thesis] Rio de Janeiro: Universidade Federal FluminenseRama, N., Monteiro, A., Bernardo, J.E., Eugénio, L., Antunes, M.J., Lung metastases from colorectal cancer: Surgical resection and prognostic factors (2009) Eur J Cardiothorac Surg., 35 (3), pp. 444-449. , http://dx.doi.org/10.1016/j.ejcts.2008.10.047, PMid:19136273Pfannschmidt, J., Dienemann, H., Hoffmann, H., Surgical resection of pulmonary metastases from colorectal cancer: A systematic review of published series (2007) Ann Thorac Surg., 84 (1), pp. 324-338. , http://dx.doi.org/10.1016/j.athoracsur.2007.02.093, PMid:17588454Ike, H., Shimada, H., Ohki, S., Togo, S., Yamaguchi, S., Ichikawa, Y., Results of aggressive resection of lung metastases from colorectal carcinoma detected by intensive follow-up (2002) Dis Colon Rectum., 45 (4), pp. 468-473. , http://dx.doi.org/10.1007/s10350-004-6222-0, discussion 473-5 PMid:12006927Inoue, M., Ohta, M., Iuchi, K., Matsumura, A., Ideguchi, K., Yasumitsu, T., Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma (2004) Ann Thorac Surg., 78 (1), pp. 238-244. , http://dx.doi.org/10.1016/j.athoracsur.2004.02.017, PMid:15223436Monteiro, A., Arce, N., Bernardo, J., Eugénio, L., Antunes, M.J., Surgical resection of lung metastases from epithelial tumors (2004) Ann Thorac Surg., 77 (2), pp. 431-437. , http://dx.doi.org/10.1016/j.athoracsur.2003.06.012, PMid:14759411Groeger, A.M., Kandioler, M.R., Mueller, M.R., End, A., Eckersberger, F., Wolner, E., Survival after surgical treatment of recurrent pulmonary metastases (1997) Eur J Cardiothorac Surg., 12, pp. 703-705. , http://dx.doi.org/10.1016/S1010-7940(97)00239-XMauro Rossi, B., Lopes, A., Paulo Kowalski, L., de Oliveira Regazzini, R.C., Prognostic factors in 291 patients with pulmonary metastases submitted to thoracotomy (1995) Sao Paulo Med J., 113 (3), pp. 910-916. , http://dx.doi.org/10.1590/S1516-31801995000300005, PMid:8728726Kanemitsu, Y., Kato, T., Hirai, T., Yasui, K., Preoperative probability model for predicting overall survival after resection of pulmonary metastases from colorectal cancer (2004) Br J Surg., 91 (1), pp. 112-120. , http://dx.doi.org/10.1002/bjs.4370, PMid:14716804Lee, W.S., Yun, S.H., Chun, H.K., Lee, W.Y., Yun, H.R., Kim, J., Pulmonary resection for metastases from colorectal cancer: Prognostic factors and survival (2007) Int J Colorectal Dis., 22 (6), pp. 699-704. , http://dx.doi.org/10.1007/s00384-006-0218-2, PMid:1710910

Exercise training reduces pulmonary ischaemia-reperfusion-induced inflammatory responses

Physical exercise reduces the deleterious effects of cardiovascular and inflammatory disorders. The purpose of the present study was to evaluate the beneficial effects of physical training on the inflammatory responses following lung ischaemia-reperfusion (IR) in rats. Male Wistar rats were divided into sham-operated animals and sedentary and trained animals submitted to lung IR. The run training programme consisted of 5 sessions(.)week(-1), each lasting 60 min(.)day(-1), at 66% of maximal oxygen consumption for 8 weeks. The left pulmonary artery, bronchus and pulmonary vein were occluded for 90 min and reperfused for 2 h. Lung protein extravasation was measured as I-125-human albumin accumulation, whereas lung neutrophil infiltration was measured as myeloperoxidase activity. Lung IR in sedentary rats resulted in marked increases in protein extravasation and neutrophil influx, and in significant elevations of serum tumour necrosis factor (TNF)-alpha and interieukin (IL)-1 beta levels. Physical preconditioning attenuated the increased IR-induced protein leakage without affecting neutrophil influx. It also reduced serum TNF-alpha (and IL-1 beta) levels, but had no effect on IL-10 levels. Plasma superoxide dismutase activity was significantly increased in trained IR rats. The present data show that physical preconditioning protects the rat lung from ischaemia-reperfusion injury by attenuating the pulmonary vascular permeability that may be a consequence of reduced levels of tumour necrosis factor-alpha and interieukin-1 beta and elevated superoxide dismutase activity31364564