Bronchopulmonary disease: III

Ann Thorac 1995;6053-59

PRACTKE

Sq

Bronchopulmonary 494.0

Bronchiectasis

(saccular,

Procedure:

31622

Bronchoscopy,

diagnostic,

32480

Lobectomy,

1)

Recurrent

pneumonia

2)

Localized

bronchiectasis,

3)

Hemoptysis,

4)

Adequate predicted postoperative lung function to undergo resection ventilator-y reserve for an acceptable postoperative quality of life

1)

Review

2)

Computed

3)

Bronchoscopy

1)

Acute

2)

Severely

3)

Limited

4)

Diffuse multicentric

bronchiectasis

5)

Inability

to localize

the source of hemoptysis

1)

Sputum

smear and culture

2)

Pulmonary

Confirmation of Indication:

Contraindications:

Actions Prior to Procedure:

a)

Actions During Procedure:

Following Procedure:

fusiform,

and refractory

to medical

treatment

recurrent

current

tomographic

scan of the chest

(diagnostic

and therapeutic)

and/or

bronchography

pneumonia

impaired

lung function

cardiovascular

reserve

function

Differential

with sensitivies

studies (split)

functions

(with

or without

4)

Optimal

control

5)

Bronchial

6)

Anesthesiology

1)

Bronchoscopy

2)

Placement of double-lumen flooding of the dependent

3)

Segmental

or lobar resection

1)

Placement planned

of single-lumen

of infection

arteriography

Bronchoscopy

and have

and past radiographs

uncontrolled

with

rarely

if indicated chest percussion) antibiotics

indicated

consultation (optional)

to clear airways (tracheal lung

divider)

of diseased endotracheal

tube by anesthesiologist

portions

to prevent

of the lung

tube if postoperative

ventilator

therapy

(if needed)

Antibiotic

therapy

Epidural

analgesia

by preoperative to optimize

Removal of chest tubes when and fluid production is scant Focus on pain control Patient-controlled

Incentive

or rigid

symptomatic,

drainage

7)

or postinfectious)

total or segmental

Postural

a)

recurrent

flexible

3)

6)

sz

Disease: III

Diagnosis:

Indication:

Actions

GUIDELINES

spirometer

cultures

ability remaining

to promote

cough,

analgesia frequently

to cough and expand

used

lung has expanded, mobility,

lung if indicated air leak has ceased,

and reexpansion

of lung

S24

PRACTICE

Ann

GUIDELINES

Outcome:

Complications:

1)

Cessation

of recurrent

pneumonia

2)

Pneumonia

3)

Discharge

from the hospital

4)

Adequate

pulmonary

1)

Prolonged

air leak

2)

Pneumonia

3)

Atelectasis

4)

Wound

5)

Bleeding

within

7 days following

reserve

infection from the lung

Reference 1. Shields TW, ed. General thoracic surgery. 4th ed. Philadelphia:

Lea & Febiger,

1994.

surgery

Thorac Surg 1995;60%-59