Strategies for Cardiopulmonary Exercise Testing of Pectus Excavatum Patients

Abstract

Malek MH, Coburn JW. Strategies for cardiopulmonary exercise testing of pectus excavatum patients. Clinics. 2008;63:245-54.The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.

Outcomes in adult pectus excavatum patients undergoing Nuss repair

“… 9 , 19 , 25 , 26 , 31 , 32 Cardiopulmonary exercise testing has been used to assess exercise capacity and limitations in peak oxygen uptake and O 2 pulse which can result as a consequence of the pectus deformity. 18 , 19 , 33 , 34 Publications as to the benefits of surgical correction have varied. 8 , 19 , 31 , 35 Several studies have reported that the cardiopulmonary function has improved significantly with increase in the oxygen consumption (VO 2 ) and O 2 pulse after surgical repair of PEx.…”

“…Cardiac output and deconditioning can occur with postoperative inactivity; 36 therefore, the patient’s exercise history can affect the measurements of VO 2 and may cause more impact on short-term testing results. 34 …”

Cardiopulmonary Function in Thoracic Wall Deformities: What Do We Really Know?

“…49 CPET is one of the most reliable methods to measure the ability to exercise and can be used to assess exercise capacity, ventilator response, and limitations in peak oxygen uptake (VO 2max , mL/min/kg) in patients with PE. 33,46,50,51 In general, peak oxygen uptake (VO 2max , mL/min/kg) and oxygen pulse (O 2 pulse/mL) have been the main components of PE evaluation. VO 2max is most commonly reported for assessment of exercise capacity.…”

“…61 Evaluation of patients in the early postoperative period affects the measurements of the VO 2 and impacts test results. 51 The majority of studies utilizing CPET in the first year after surgery failed to demonstrate cardiovascular improvement after surgical repair, however, are all potentially subject to the confounding influence of physical deconditioning. 35,57 Deconditioning is in and of itself a mild form of cardiovascular impairment associated with higher heart rates and greater ventilator requirement during exercise.…”

Artigos publicados em periódicos brasileiros de interesse para a medicina do exercício e do esporte: uma revisão

“…These strategies are aimed at doctors, pneumology professionals and exercise physiologists, among other professionals of the health care field who carry out exercise cardiopulmonary tests in patients with pectus excavatum. The use of strategies described in this article enables comparisons between studies, and the effects of the pectus excavatum condition in the cardiopulmonary function can be evaluated in more detail (10) .…”