POSTOPERATIVE IMPAIRMENT OF MUCOUS TRANSPORT IN LUNG

Publisher Website
Google Scholar
Abstract
Impairment of mucous transport is considered significant to the postoperative development of atelectasis but the association was never demonstrated in humans. Ta powder, which adheres to airway mucus, can be used to study mucociliary transport. The postoperative clearance of insufflated Ta powder (mean diameter, 2.5 .mu.m) was investigated in 25 patients. Eighteen patients underwent intra-abdominal vascular surgery and 7 underwent lower-extremity orthopedic procedures. At the completion of surgery, Ta was insufflated into both lungs of each patient to outline a representative sample of airways from the trachea to the small bronchi. Ta clearance was evaluated from serial radiographs obtained immediately after insufflation, at approximately 6, 18, 26 and 48 h later, and thereafter whenever appropriate. In the 7 orthopedic patients, clearance of Ta was progressive and usually complete within 48 h. Atelectasis did not occur in this group. In 14 of the 18 patients who had abdominal surgery, mucociliary clearance was markedly abnormal in that Ta was retained for up to 6 days. Pooling of Ta-labeled mucus occurred in dependent bronchi in 16 of these 18 patients. Pooling preceded and always accompanied radiographically visible atelectasis. Lobar atelectasis occurred in 6 patients and segmental atelectasis in 8. Ta-labeled mucus moved peripherally in atelectatic lobes or segments and was retained in these bronchi until re-expansion took place. Impaired ciliary function and mucous transport are apparently associated with and implicated in postoperative pulmonary atelectasis.

This publication has 1 reference indexed in Scilit: