Carbon monoxide lung diffusion capacity improves risk stratification in patients without airflow limitation: evidence for systematic measurement before lung resection

Brunelli, Alessandro; Refai, Majed; Salati, Michele; Sabbatini, Armando; Morgan‐Hughes, Nicholas J.; Rocco, Gaetano

doi:10.1016/j.ejcts.2006.01.014

Cited by 120 publications

(65 citation statements)

References 14 publications

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“…More recently, the most commonly used functional algorithms for preoperative assessment suggest to consider the predicted post-operative (ppo) FEV 1 in choosing further tests or even excluding patients from operation without further tests (61). A value of ppoFEV 1 <40% is currently used to distinguish between normal risk and higher risk lung resection patients (62). However, ppoFEV 1 clearly overestimates the actual FEV 1 observed during the first postoperative period, when most of the complications are observed (63).…”

Section: Assessment Of Elderly Patients Before Surgerymentioning

confidence: 99%

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Lung cancer in elderly patients

et al. 2016

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Section: Assessment Of Elderly Patients Before Surgerymentioning

confidence: 99%

“…However, ppoFEV 1 clearly overestimates the actual FEV 1 observed during the first postoperative period, when most of the complications are observed (63). Assessment of DLCO and VO 2 max may be required to further improve preoperative assessment (62).…”

Section: Assessment Of Elderly Patients Before Surgerymentioning

confidence: 99%

Lung cancer in elderly patients

et al. 2016

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“…In addition, a reduced ppoDLCO has been shown to be a predictor of cardiopulmonary morbidity and mortality not only in patients with reduced FEV 1 but also in those with normal respiratory function (37)(38)(39). Based on these evidences recent functional guidelines (1,5) recommend the measurement of DLCO in all candidates to lung resection regardless their preoperative FEV 1 value.…”

Section: Pulmonary Function Evaluationmentioning

confidence: 99%

“…Recent papers have shown that the FEV 1 and DLCO are poorly correlated and that more than 40% of patients with normal FEV 1 (>80%) may have DLCO <80%, and 7% of them may have a ppoDLCO <40% (37).…”

Section: Pulmonary Function Evaluationmentioning

confidence: 99%

Preoperative functional workup for patients with advanced lung cancer

Brunelli

2016

J. Thorac. Dis.

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Locally advanced lung cancer remains a surgical indication in selected patients. This condition often demands larger resections. As a consequence preoperative functional workup is of paramount importance to stratify the risk and choose the most appropriate treatment. We reviewed the current evidence on functional evaluation with a special focus on specific aspects related to locally advanced lung cancer stages (i.e., risk after neoadjuvant treatment, pneumonectomy). Evidence is discussed to provide information that could assist clinicians in their preoperative workup of these challenging patients.

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“…The DL,CO, which is already a valuable tool for disease diagnosis [3][4][5][6], is also an important measurement used to identify subtle adverse effects of inhaled therapies on the diffusing capacity in clinical trials.…”

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confidence: 99%

Quality control ofD_L,COinstruments in global clinical trials

Jensen

Leyk²,

Crapo³

et al. 2009

Eur Respir J

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High inter-and intra-laboratory variability exists for the single-breath diffusing capacity of the lung for carbon monoxide (DL,CO) test. To detect small changes in diffusing capacity in multicentre clinical trials, accurate measurements are essential. The present study assessed whether regular DL,CO simulator testing maintained or improved instrument accuracy and reduced variability in multicentre trials.The 125 pulmonary function testing laboratories that participated in clinical trials for AIR1 Inhaled Insulin validated and monitored the accuracy of their DL,CO measuring devices using a DL,CO simulator, which creates known target values for any device. Devices measuring a simulated DL,CO different from target by .3 mL?min-1?mmHg -1 failed testing and were serviced.Device accuracy was assessed over time and with respect to differences in several variables. Initially, 31 (25%) laboratories had a DL,CO device that failed simulator testing. After fixing or replacing devices, 124 (99%) laboratories had passing devices. The percentage of failed tests significantly decreased over time. Differences in geographical region, device type, breath-hold time, temperature and pressure were not associated with meaningful differences in DL,CO device accuracy.Regular diffusing capacity of the lung for carbon monoxide simulator testing allows pulmonary function testing laboratories to maintain the accuracy of their diffusing capacity measurements, leading to reduced variability across laboratories in multicentre clinical trials.

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Carbon monoxide lung diffusion capacity improves risk stratification in patients without airflow limitation: evidence for systematic measurement before lung resection

Cited by 120 publications

References 14 publications

Lung cancer in elderly patients

Lung cancer in elderly patients

Preoperative functional workup for patients with advanced lung cancer

Quality control ofD_L,COinstruments in global clinical trials

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Carbon monoxide lung diffusion capacity improves risk stratification in patients without airflow limitation: evidence for systematic measurement before lung resection

Cited by 120 publications

References 14 publications

Lung cancer in elderly patients

Lung cancer in elderly patients

Preoperative functional workup for patients with advanced lung cancer

Quality control ofDL,COinstruments in global clinical trials

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Product

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Quality control ofD_L,COinstruments in global clinical trials