Studies in patients who underwent pulmonary resection revealed that respiratory function is not seriously impaired when the remaining lung is normal. Even patients with generalized pulmonary disease should not be denied necessary resection on the basis of routine pulmonary function studies. Evaluation of right-left split function is indicated in patients with compromised ventilatory capabilities. Non-invasive methods are certainly preferable for this evaluation because of less hazard to the patient and the lower costs. However, the ability of the cardiovascular system to compensate for a reduction in the pulmonary vascular bed following pulmonary resection is as important as the ventilatory compensation, and any evaluation that does not include both heart and lung functions has to be incomplete. Measurements of the distribution of perfusion between the lungs during exercise at flow rates where little further dilatation of the pulmonary vascular system can be expected currently seem to give satisfactory prognostic information, especially when combined with subjective responses. Cardiac catheterization with unilateral balloon occlusion of the pulmonary artery could be reserved for patients in whom the status of perfusion is equivocal.
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine