Association Between One-Lung Ventilation Parameters and Postoperative Pulmonary Infection After Radical Lung Cancer Surgery: A Retrospective Cohort Study
Abstract
Objectives: To investigate the relationship between lung-protective parameters during one-lung ventilation (OLV) and the risk of postoperative pulmonary infection (PPI) after radical lung cancer (LC) surgery.
Methods: This retrospective study included 319 patients with non-small cell LC who underwent radical LC surgery with OLV during January 1, 2022-December 31, 2025. Patients were divided into PPI (n = 35) and non-PPI (n = 284) groups based on whether PPI occurred during postoperative hospitalization. Baseline data, preoperative pulmonary function, and intraoperative OLV parameters were collected. Logistic regression analyses were performed to identify relevant factors. The discriminatory ability of the multivariable model was evaluated using the receiver operating characteristic (ROC) curve.
Results: The incidence of PPI was 11.0%. Compared with the non-PPI group, the PPI group had older age, a higher proportion of hypertension, lower forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF), a higher proportion of open thoracic surgery, higher tidal volume (VT), higher inspiratory pressure, higher ventilation frequency, and higher fraction of inspired oxygen (FiO2), but lower positive end-expiratory pressure (PEEP) (all P < .05). Multivariable logistic regression analysis showed that hypertension, lower FEV1, open thoracic surgery, higher inspiratory pressure, and higher FiO2 were independently associated with PPI (all P < .05). The AUC of the model constructed based on these independent factors was 0.856 (95% CI, 0.782-0.906).
Conclusions: Lung-protective parameters during OLV are associated with PPI after radical LC surgery. Notably, higher inspiratory pressure and higher FiO2 remain independently associated with PPI after adjusting for confounding factors.
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BibTeX
@article{chen2026association,
title = {{Association Between One-Lung Ventilation Parameters and Postoperative Pulmonary Infection After Radical Lung Cancer Surgery: A Retrospective Cohort Study}},
author = {Qianming Chen and Zhuangwen Hu and Yu Sheng and Zhenlin Jiang},
journal = {Interdisciplinary Cardiovascular and Thoracic Surgery},
year = {2026},
month = aug,
doi = {10.1093/icvts/ivag237},
url = {https://doi.org/10.1093/icvts/ivag237},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Association Between One-Lung Ventilation Parameters and Postoperative Pulmonary Infection After Radical Lung Cancer Surgery: A Retrospective Cohort Study
AU - Qianming Chen
AU - Zhuangwen Hu
AU - Yu Sheng
AU - Zhenlin Jiang
PY - 2026
DA - 2026/08/25
JO - Interdisciplinary Cardiovascular and Thoracic Surgery
DO - 10.1093/icvts/ivag237
UR - https://doi.org/10.1093/icvts/ivag237
AB - Objectives: To investigate the relationship between lung-protective parameters during one-lung ventilation (OLV) and the risk of postoperative pulmonary infection (PPI) after radical lung cancer (LC) surgery. Methods: This retrospective study included 319 patients with non-small cell LC who underwent radical LC surgery with OLV during January 1, 2022-December 31, 2025. Patients were divided into PPI (n = 35) and non-PPI (n = 284) groups based on whether PPI occurred during postoperative hospitalization. Baseline data, preoperative pulmonary function, and intraoperative OLV parameters were collected. Logistic regression analyses were performed to identify relevant factors. The discriminatory ability of the multivariable model was evaluated using the receiver operating characteristic (ROC) curve. Results: The incidence of PPI was 11.0%. Compared with the non-PPI group, the PPI group had older age, a higher proportion of hypertension, lower forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF), a higher proportion of open thoracic surgery, higher tidal volume (VT), higher inspiratory pressure, higher ventilation frequency, and higher fraction of inspired oxygen (FiO2), but lower positive end-expiratory pressure (PEEP) (all P < .05). Multivariable logistic regression analysis showed that hypertension, lower FEV1, open thoracic surgery, higher inspiratory pressure, and higher FiO2 were independently associated with PPI (all P < .05). The AUC of the model constructed based on these independent factors was 0.856 (95% CI, 0.782-0.906). Conclusions: Lung-protective parameters during OLV are associated with PPI after radical LC surgery. Notably, higher inspiratory pressure and higher FiO2 remain independently associated with PPI after adjusting for confounding factors.
SN - 2753-670X
ER -