Bronchial healing remains one of the dominant issues in lung transplantation. Among other factors, the quality of airway protection during procurement may contribute to improve bronchial healing. In most centers lung preservation is performed using the pulmonary artery (PA) flush perfusion (FP). The present study was performed to investigate the influence of different routes of perfusion on the distribution of Euro-Collins solution (EUC) in lung parenchyma and upper airways in swine. The animals were divided into 4 groups, 1 without FP; Control (n=6), and the others with EUC delivery via: pulmonary artery (PA) (n=6); pulmonary and bronchial arteries simultaneously (PA+BA) (n=8), and pulmonary veins (PV). Lungs and airways were assessed by the following methods: dye-labeled microspheres for total and regional perfusion, tissue water content, and lung temperature. There was no significant difference in total lung flow between PA+BA and PA, both superior to the PV group. Flow in the proximal and distal trachea were significantly increased: PA+BA (0.970 ± 0.4 and 0.380 ± 0.2 mL/min/g, respectively); PA ( 0.023 ± 0.007 and 0.024 ± 0.07 mL/min/g, respectively); PV (0.009 ± 0.003 and 0.021 ± 0.006 mL/min/g respectively) and Control experiments (0.125 ± 0.0018 and 0.105 ±0.012 mL/min/g, respectively). The highest flow rates in the right main bronchus were achieved by PA+BA (1.04 ± 0.4 mL/min/g) as comparison to Control, PA, and PV groups (0.11 ± 0.03, 0.033 ± 0.008, and 0.019 ± 0.005 mL/min/g, respectively). Flows in the left main bronchus were significantly increased by PA+BA (0.97 ± 0.3 mL/min/g), as comparison to control, PA and PV groups (0.09 ± 0.02, 0.045 ± 0.012, and 0.027 ± 0.006 mL/min/g, respectively). In conclusion, these data showed that the distribution of EUC in airways of swine is significantly improved by PA+BA perfusion.

Keywords: Lung transplantation. Flush perfusion. Bronchial circulation. Bronchial complications.

4 - Functional respiratory changes in laparoscopic cholecystectomy

Alterações funcionais respiratórias na colecistectomia por via laparoscópica

Luciana Dias Chiavegato, José Roberto Jardim, Sonia Maria Faresin, Yara Juliano

J Bras Pneumol.1997;23(2):69-76

Objective: The aim of this study was to measure the changes in lung volume, pulmonary ventilation, maximum respiratory muscle strength, and the incidence of pulmonary complications in patients undergoing elective laparoscopic cholecystectomy. Type of study: Prospective study. Material and methods: Twenty patients (7 men and 13 women) with mean age of 42.7 years with normal respiratory function were studied. All patients in the preoperative period answered a long questionnaire, had a physical examination done, and had their lung volumes, respiratory muscle strength, diaphragmatic index and pulse oximetry determined. All measurements were repeated on the 1st, 2nd, 3rd and 6th postoperative days. Results: Patients showed a significant decrease (p < 0.05) on the first postoperative day: 26% ± 13% in tidal volume; 20% ± 14% in minute volume; 36% ± 17% in vital capacity; 47% ± 17% in maximum inspiratory pressure, 39% ± 27% in the maximum expiratory pressure and 36% ± 25% in diaphragmatic index. Tidal volume, minute volume and maximum expiratory pressure returned to their basal values on the third postoperative day; vital capacity, maximum inspiratory pressure and diaphragmatic index returned to their basal values between the 4th and 6th postoperative days. Among the 20 patients pulmonary complication was observed in just one patient (lobar atelectasis); there was a full recovery by the third postoperative day with the use of chest physical therapy techniques. Conclusion: The authors conclude that patients undergoing a laparoscopic cholecystectomy show a significant decrease in lung volume and in respiratory muscle strength on the first postoperative day. But, when these measurements are compared to the literature, return to their basal values is faster (between the 4th and 6th postoperative days) than with conventional surgery.

Keywords: Laparoscopic surgery, preoperative and postoperative care and respiratory muscle strength.

5 - Pneumonia por "Pneumocystis carinii" em pacientes com e sem SIDA: reavaliação

"Pneumocystis carinii" pneumonia in patients with and without AIDS: a reappraisal

Carloss Viegas, Ronald FCCP, Collman G

J Bras Pneumol.1997;23(2):79-82

Endoscopia respiratória

6 - Saber-sheath trachea: clinic-tomographic-endoscopic-functional correlation

Traquéia em bainha de sabre ("saber-sheath trachea"): correlação clínico-tomográfico-endoscópico-funcional

Jorge Luiz Pereira-Silva, Tereza Villas-Bôas Veloso, Márcia Maria Magalhães de Almeida e Marinho, Luiz Eduardo Lago de Castro, Guilherme Sóstenes da Costa Montal

J Bras Pneumol.1997;23(2):83-86

Review Article

7 - Radiation therapy alone versus combined chemotherapy and radiation therapy in locally advanced non-small cell lung carcinoma (stages IIIA and IIIB).

Radioterapia exclusiva "versus" radioterapia associada à quimioterapia no carcinoma de pulmão não de pequenas células localmente avançado (estádios IIIA e IIIB)

Heloisa de Andrade Carvalho

J Bras Pneumol.1997;23(2):87-92

8 - Broncodilatadores beta-adrenérgicos de longa duração Segurança, eficácia e indicações

José Ângelo Rizzo

J Bras Pneumol.1997;23(2):93-100

Case Report

9 - Thoracotomy with pulmonary resection in trauma

Toracotomia com ressecção pulmonar no trauma

Roger Normando, Marco Antônio Franco Tavares, Antônio Guilherme Guimarães, Adenard Cunha, Marcello Rickmann Lobato

J Bras Pneumol.1997;23(2):101-104

10 - Giant pneumatoceles: report of a case

Pneumatoceles gigantes: relato de caso

Vivian Kiran Lee, Antônio Carlos Pastorino, Joselina Magalhães Andrade Cardieri, Tatiana Rozov

J Bras Pneumol.1997;23(2):105-109

11 - Alterações pulmonares na macroglobulinemia de Waldenström

Renato de Albuquerque Medeiros, Jucineide Araújo, José Kerbauy, Miguel Bogossian

J Bras Pneumol.1997;23(2):110-112

Next Issue

Year 1997 - Volume 23 - Issue 2 (March/April)

Editorial

1 - Pneumonia por "Pneumocystis carinii": tratar ou investigar?

Original Article

2 - Management of "Pneumocystis carinii" pneumonia in HIV-infected patients: empiric treatment versus microscopic confirmation

Controle da pneumonia por "Pneumocystis carinii" em pacientes HIV-positivos: tratamento empírico "versus" confirmação microscópica

3 - The saccharin test (ST) in children

Teste de sacarina em crianças

4 - Distribution of the Euro-Collins solution in swine lungs, given through different rapid perfusion routes: a comparative study

Distribuição da solução Euro-Collins em pulmões de porcos ministrada por diferentes vias de perfusão rápida: estudo comparativo