Overstreet Shana, Parekh Kalpaj R, Gross Thomas J
Departments of Respiratory Care, Carver College of Medicine, University of Iowa Health Care, USA.
Departments of Cardiothoracic Surgery, Carver College of Medicine, University of Iowa Health Care, USA.
Respir Med Case Rep. 2015 Jun 12;16:11-4. doi: 10.1016/j.rmcr.2015.06.004. eCollection 2015.
A patient presents with a new bronchogenic carcinoma 5 years after laryngectomy for recurrent laryngeal tumor and 13 years after chemoradiation for concurrent lung cancer with synchronous base-of-tongue tumor. Due to his complex history and perceived limited respiratory reserve, he was felt high risk for the completion pneumonectomy needed for resection of this new tumor. The attending surgeon requested a full cardiopulmonary exercise test for risk assessment prior to surgery. We found that there was no commercially available connector that would allow our CPET equipment to reliably collect respiratory gases from a patient with tracheostomy stoma or tube. We report here a simple coupling devised "in house" that allowed for the performance of an interpretable test leading to a significant change in medical care.
一名患者在因复发性喉肿瘤行喉切除术后5年，以及因同步舌根肿瘤合并肺癌接受放化疗后13年，被诊断出患有新的支气管源性癌。鉴于其复杂的病史以及认为其呼吸储备有限，对于切除这一新肿瘤所需的全肺切除术，他被视为高风险患者。主刀医生在手术前要求进行全面的心肺运动试验以评估风险。我们发现没有市售的连接器能够让我们的心肺运动试验设备从有气管造口或气管插管的患者可靠地收集呼吸气体。我们在此报告一种在内部设计的简单连接件，它使得能够进行可解读的测试，从而显著改变了医疗护理。
