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British Journal of Anaesthesia, 2001, Vol. 86, No. 5 633-638
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Peri-operative risk factors for acute lung injury after elective oesophagectomy{dagger}

S. Tandon1, A. Batchelor1, R. Bullock1, A. Gascoigne1, M. Griffin2, N. Hayes2, J. Hing3, I. Shaw1, I. Warnell1 and S. V. Baudouin1,3

1Departments of Anaesthesia and Intensive Care Medicine, Newcastle upon Tyne NHS Trust, Newcastle upon Tyne, UK. 2Northern Oesophago-gastric Unit, Newcastle upon Tyne NHS Trust, Newcastle upon Tyne, UK. 3University Department of Surgical and Reproductive Sciences, University of Newcastle upon Tyne, UK*Corresponding author: Department of Anaesthesia, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK

{dagger}This article is accompanied by Editorial II.

Acute lung injury after oesophagectomy is well recognized but the risk factors associated with its development are poorly defined. We analysed retrospectively the effect of a number of pre-, peri- and post-operative risk factors on the development of lung injury in 168 patients after elective oesophagectomy performed at a single centre. The acute respiratory distress syndrome (ARDS) developed in 14.5% of patients and acute lung injury in 23.8%. Mortality in patients developing ARDS was 50% compared with 3.5% in the remainder. Features associated with the development of ARDS included a low pre-operative body mass index, a history of cigarette smoking, the experience of the surgeon, the duration of both the operation and of one-lung ventilation, and the occurrence of a post-operative anastomotic leak. Peri-operative cardiorespiratory instability (measured by peri-operative hypoxaemia, hypotension, fluid and blood requirements and the need for inotropic support) was also associated with ARDS. Acute lung injury after elective oesophagectomy is associated with intraoperative cardiorespiratory instability.

Br J Anaesth 2001; 86: 633–8


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