ArticleChest2016
Pleural Hypercarbia After Lung Surgery Is Associated With Persistent Alveolopleural Fistulae.
Article in Chest, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 27 citations in OpenAlex.
- Endoluminal approaches to postoperative air leaks.Journal of thoracic disease · 2026Review
- Sensing molecular carbon dioxide: a translational focus for respiratory disease.Physiological reviews · 2025Review
- Gene Expression Profiling of Pancreatic Ductal Adenocarcinoma Cells in Hypercapnia Identifies SIAH3 as a Novel Prognostic Biomarker.International journal of molecular sciences · 2025Article
- Is chest tube capnography effective in differentiating between true and false air leaks after minimally invasive thoracic surgery?General thoracic and cardiovascular surgery · 2024Observational
- Chest drainage outcomes by water seal versus low suction on digital drainage systems after lung resection: retrospective study.Journal of thoracic disease · 2024Article
- Drainology: Leveraging research in chest-drain management to enhance recovery after cardiothoracic surgery.JTCVS techniques · 2024Article
- Hypercapnia alters stroma-derived Wnt production to limit β-catenin signaling and proliferation in AT2 cells.JCI insight · 2023Article
- Elevated COInterface focus · 2021Review
- Hypercapnia: An Aggravating Factor in Asthma.Journal of clinical medicine · 2020Review
- Correlation of Arterial COJournal of clinical medicine · 2020Article
- High COAmerican journal of respiratory cell and molecular biology · 2020Article
- Hypercapnia Regulates Gene Expression and Tissue Function.Frontiers in physiology · 2020Review
- Elevated COScientific reports · 2019Article
- Prolonged air leak following lobectomy can be predicted in lung cancer patients.Surgery today · 2017Article
- Effects of hypercapnia on the lung.The Journal of physiology · 2017Review
- Severe hypercapnia and outcome of mechanically ventilated patients with moderate or severe acute respiratory distress syndrome.Intensive care medicine · 2017Article
- Pleural gas analysis for the identification of alveolopleural fistulae.Current opinion in pulmonary medicine · 2016Review
- Air leak after lung resection: pathophysiology and patients' implications.Journal of thoracic disease · 2016Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPersistent air leak (PAL) > 5 days due to alveolopleural fistulae is a leading cause of morbidity following surgical resection. Elevated CO2 levels reportedly inhibit alveolar epithelial cell proliferation and impair wound healing in vitro. Because the injured lung surface is in direct communication with the pleural cavity, we investigated whether the pleural gaseous milieu affected lung healing.
methodsOxygen and CO2 levels in pleural gas were determined prospectively in consecutive patients (N = 116) undergoing lung resection by using an infrared spectroscopy-based analyzer. Poisson and logistic regression analyses were used to determine the relationship between time to resolution of air leaks and pleural oxygen and CO2. In addition, patients with pleural CO2 concentrations ? 6% on postoperative day 1 (n = 20) were alternatively treated with supplemental oxygen and extrapleural suction to reduce the pleural CO2 levels.
resultsPoisson analyses revealed that every 1% increase in CO2 was associated with a delay in resolution of air leak by 9 h (95% CI, 7.1 to 10.8; P < .001). Linear regression showed that every 1% increase in CO2 increased the odds of PAL by 10-fold (95% CI, 2.2 to 47.8; P = .003). In patients with pleural CO2 ? 6%, a reduction in CO2 promoted resolution of air leak (6.0 ± 1.2 vs 3.4 ± 1.1 days; P < .001).
conclusionsPleural hypercarbia seems to be associated with persistent alveolopleural fistulae following lung resection. Analysis of pleural gases could allow for better chest tube management following lung resection. Patients with intrapleural hypercarbia seem to benefit from supplemental oxygen and suction, whereas patients who do not have hypercarbia can be maintained on water seal drainage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.