Effect of acute lung volume reduction surgery on lung mechanics and maximal flow in a canine model of upper lobe emphysema

In severe pulmonary emphysema, lung volume reduction surgery (LVRS) is a palliative surgical procedure that has been shown to improve lung function and maximal expiratory flow in selected patients. However, in the immediate perioperative period, the acute physiologic changes following LVRS are not fully understood and may represent a period of potentially high morbidity. The changes in parameters of maximal expiratory flow limitation that occur immediately following lung volume reduction surgery in a canine model of upper lobe emphysema were investigated in this study.; Healthy dogs were randomized to undergo development of bilateral upper lobe emphysema (n=9) through repeated bronchoscopic instillations of the proteolytic enzyme papain or to serve as healthy controls (n=8). Satisfactory development of emphysema was confirmed by measuring lung volumes at baseline and after serial papain administration and noting an increase in total lung capacity (TLC) to 120% of the pre-emphysema value. Dogs with and without emphysema were then randomized to have LVRS or to serve in time control groups. (Abstract shortened by UMI.)...