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Preoperative maximal exercise oxygen consumption test predicts postoperative pulmonary morbidity following major lung resection
Author(s) -
BAYRAM Ahmet Sami,
CANDAN Tari̇k,
GEBITEKIN Cengiz
Publication year - 2007
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2007.01097.x
Subject(s) - medicine , pneumonectomy , cardiopulmonary bypass , surgery , vo2 max , lung , respiratory disease , cardiopulmonary exercise test , anesthesia , heart rate , blood pressure
Background and objective: Pulmonary resection carries a significant morbidity and mortality. The utility of maximal oxygen uptake test (VO 2 max) to predict cardiopulmonary complications following major pulmonary resection was evaluated. Methods: Following standard preoperative work‐up and VO 2 max testing, 55 patients (49 male; mean age 59 years, range 20–74) underwent major pulmonary surgery: lobectomy ( n = 31), bilobectomy ( n = 6) and pneumonectomy ( n = 18). An investigator blinded to the preoperative assessment prospectively collected data on postoperative cardiopulmonary complications. Patients were divided into two groups according to preoperative VO 2 max and also according to FEV 1 . The frequency of postoperative complications in the groups was compared. Results: Complications were observed in 19 (34.5%) patients, 11 of which were pulmonary (20%). There were two deaths (3.6%), both due to respiratory failure. Preoperative FEV 1 failed to predict postoperative respiratory complications. Five of 36 patients with a preoperative FEV 1 > 2 L suffered pulmonary complications, compared with six of 19 patients with FEV 1 < 2 L. Cardiopulmonary complications were not observed in patients with VO 2 max > 15 mL/kg/min ( n = 27); however, 11 patients with VO 2 max < 15 mL/kg/min ( n = 28) suffered cardiopulmonary complications ( P < 0.05). Conclusion: VO 2 max predicts postoperative pulmonary complications following major lung resection, and the risk of complications increases significantly when the preoperative VO 2 max is less than 15 mL/kg/min.