Pulmonary
fibrosis |
Chemotherapy: Bleomycin (Blenoxane), lomustine (CCNU), carmustine (BCNU), cyclophosphamide, methotrexate, mitomycin, vinca alkaloids |
Fatigue, cough, dyspnea on exertion, reduced exercise tolerance, orthopnea, cyanosis, finger clubbing, rales, cor pulmonale |
Baseline chest x-ray and O2 saturation, pulmonary function test including diffusing capacity for carbon monoxide, then every 3–5 years or as needed |
Consider pulmonary evaluation, steroid therapy; prevention: avoidance of smoking. Avoidance of infections: influenza vaccine, Pneumovax after bleomycin: avoid fractional inspired oxygen (FiO2) >30% intraoperatively and postoperatively avoid excessive hydration |