The Influense of Age and Infusion volume on the circulation and Respiration after Surgery for Esophageal Carcinoma

Chikara Kusano, Masamichi Baba, Souji Sane, Touru Kumanohoso, Kazusada Shirao, Syouji Natsugoe, Toshitaka Fukumoto, Takashi Aikou, Heiji Yoshinaka*

First Department of Surgery and Operating Center*, School of Medicine, Kagoshima University

In 69 patients with thoracic esophageal cancer, we studied postoperative hemodynamics and/or respiratory changes by using the Swan-Ganz catheter from before the operation to the fifth postoperative day. Cardiac function and pulmonary circulation were depressed in patients more than 69 years old. Seventy-nine percent of the patients younger than 60 years old showed a normal hemodynamic pattern on the operative day. On the other hand, the hypovolemic type and the cardiac failure type were more numerous among patients 60 years old or older; only 38% were normal. According to the total infusion volume from the operation to the second postoperative day, the more infusion group (80 to 120 ml/kg/day) showed a hyperdynamic state and respiratory index significantly lower than those of the less infusion group (less than 80 ml/kg/day) in patients younger than 60 years old. In contrast, the more infusion group showd depressed cardiac function and a respiratory index higher than those of the less infusion group in patients 60 years old or more. We emphasize that the postoperative management of circulation and respiration after esophagectomy should be different according to whether the patients is younger than 60 or not.

Key words
postoperative infusion of esophageal cancer, postoperative hemodynamics and respiration, Swan-Ganz catheter

Reprint requests
Chikara Kusano First Department of Surgery, School of Medicine, Kagoshima University
8-35-1 Sakuragaoka, Kagoshima City, 890 JAPAN

Accepted
January 12, 1994

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