Pulmonary function

Pulmonary function should be measured before contemplating lung resection. In a fit patient, this need be no more than basic spirometry (Fig. 18.7). Smoking, which causes lung cancer, may also lead to a degree of emphysema, and these patients require full bronchospirometry with and without bronchodilators and an estimate of pulmonary diffusion. In marginal cases, a pulmonary exercise test measuring the oxygen uptake during exercise is also helpful and a ventilation-perfusion scan, particularly if it is quantified, gives an estimate of the relative contribution of each area of the lung to the overall function. This information is helpful in estimating the likely respiratory function after pulmonary resection. Clinical evidence of pulmonary hypertension is a contraindication to major pulmonary resection and if suspected can be confirmed by non-invasive means.

Left upper lobe

Left upper lobe

Left lower lobe

Patients who have marginal pulmonary function improve if they cease smoking and are given an intensive regimen of bronchodilators and corticosteroids, and should be reassessed after 2 weeks of treatment to see if pulmonary function has improved sufficiently to allow surgery.

Coping with Asthma

Coping with Asthma

If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.

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