Bullectomy is beneficial in the pulmonary blood flow/driving pressure relationship in bullous emphysema patients

Objectives: Few physiological studies have been on pulmonary circulation, including the relationship between pulmonary blood flow and driving pressure, and viscosity changes arising from hematocrit changes before versus after lung volume reduction Surgery or bullectomy in emphysematous patients.Methods: We studied the relationship between pulmonary blood flow and driving pressure before and after bullectomy using a unilateral pulmonary artery occlusion test based on pulmonary blood flow fractions obtained by pulmonary blood flow scintigraphy in 7 patients with pulmonary emphysema associated with bullae.Results: Among the 7 undergoing bullectomy, the pulmonary blood flow/driving pressure relationship devreased in 5 and was unchanged in 2. Of the 11 lungs treated by bullectomy, this relationship decreased in 8 lungs, but not 3 (p<0.01). No significant difference was seen in oxygen partial pressure in arterial and mixed venous blood or hematocrit.Conclusion: We concluded that bullectomy shifted the pulmonary blood flow/driving pressure relationship downword in some cases with significant bullae.