Effect Of Perioperative Fluid Therapy On Postoperative Cardiopulmonary Complications Following Second Lung Resection For Lung Cancer Patients

Objective: To analyze the effect of perioperative fluid therapy on postoperative cardiopulmonary complications following second lung resection for lung cancer patients.Methods: The medical data of 45 multiple primary lung cancer patients with history of lung resection was retrospectively analyzed,including 31 males and 14 females with an average age of60.1±8.7 years.The risk factors for postoperative cardiopulmonary complications were analyzed using univariate analysis and multivariate logistic regression analysis.The threshold of infusion speed and volume was got from ROC curve and Youden index respectively.Results: Sixty cardiopulmonary complications occurred in 19 patients.The total mortality rate was 6.7%,while postoperative cardiopulmonary complication rate was 42.2%.Results of univariate analysis showed that smoking(P=0.001),FEV1%pre(P=0.017),rate of infusion of intraoperative fluids(P=0.010),total volume of intraoperativefluids(P=0.023),the amount of blood loss during operation(P=0.007),total volume of postoperative fluids in 48h(P < 0.001),liquid over-input in 3POD(P<0.001)and type of lung resection(P<0.050)were associated with major postoperative cardiopulmonary complications.Logistic regression analysis showed that rate of infusion of intraoperative fluids(OR=2.089,95%CI 1.052 ~ 4.148,P=0.035)and liquid over-input in 3POD(OR=1.010,95%CI 1.003~1.016,P=0.003)were independent risk factors for postoperative cardiopulmonary complications.The threshold of intraoperative infusion speed was 7.5ml/kg/h,meanwhile the threshold of total over-input fluid volume 3 days after operation was 780 ml.Conclusion: For lung cancer patients who underwent second lung resections,both intraoperative infusion speed and the total amount of liquid over-input in 3 days after operation are related with postoperative cardiopulmonary complications.The intraoperative infusion speed should be less than 7.5ml/kg/h,while the total amount of over-input liquid in 3days after operation should be less than 780 ml.