Cardiopulmonary Exercise Testing in the Preoperative Assessment for Lung Resection Surgery

Weisman, Idelle M.

doi:10.1053/stcs.2001.24619

Cited by 44 publications

(19 citation statements)

References 52 publications

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“…The most important concept determining the risk of surgery is that the further the procedure from the diaphragm, the lower the pulmonary complication rate. Although the value of pre-operative pulmonary function testing in general surgery is debatable, pre-operative pulmonary function studies have a well-documented role in the evaluation of patients undergoing lung surgery [64][65][66][67].…”

Section: Surgery In Copdmentioning

confidence: 99%

Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper

Celli¹,

MacNee²,

Agustí³

et al. 2004

Eur Respir J

3,792

2,756

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Section: Surgery In Copdmentioning

confidence: 99%

Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper

Celli¹,

MacNee²,

Agustí³

et al. 2004

Eur Respir J

3,792

2,756

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“…V9O 2 helps predict survival in patients undergoing lung resection [1,2] and lung volume reduction surgery (LVRS) [3], and in patients with chronic obstructive pulmonary disease (COPD) [4] and heart failure [5]. The 6-min walk test (6MWT) is easy to perform and has been standardised [6], and also predicts mortality in COPD [7,8] and in pulmonary hypertension [9].…”

mentioning

confidence: 99%

The modified BODE index: validation with mortality in COPD

Côté¹,

Pinto-Plata²,

Marı́n³

et al. 2008

European Respiratory Journal

114

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Peak oxygen uptake (V9O 2 ) remains the gold standard measurement of exercise capacity and has been associated with survival. A modified BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity) index replacing the 6-min walk distance (6MWD) with V9O 2 as % predicted (mBODE%) has been developed and found to have excellent correlation with the conventional BODE index.The objectives of the present study were to compare the ability of the conventional BODE and the mBODE% to predict mortality in 444 patients with chronic obstructive pulmonary disease (COPD) followed for a mean¡SD period of 71¡34 months. Anthropometrics, spirometry, lung volumes, comorbidity, cardiopulmonary cyclo-ergometry test and 6MWD were determined at entry.The mean BODE indices for the cohort were: BODE 4.1¡2 and mBODE% 5.5¡2. Both indices were significantly correlated with mortality. Logistic regression analysis with COPD survival as the dependent variable identified the BODE index, Charlson's and exercise capacity (in W) as variables associated with this outcome.In conclusion, the conventional BODE index, which uses the 6-min walk distance, predicts mortality in chronic obstructive pulmonary disease as well as the modified index using peak oxygen uptake. The results support the use of the simpler index, which includes the 6-min walk distance in the comprehensive evaluation of patients with chronic obstructive pulmonary disease.KEYWORDS: Chronic obstructive pulmonary disease, exercise capacity, mortality T he oxygen uptake measured at peak exercise (V9O 2 ) during incremental cardiopulmonary exercise testing (CPET) is considered to be the gold standard for the evaluation of exercise capacity. V9O 2 helps predict survival in patients undergoing lung resection [1, 2] and lung volume reduction surgery (LVRS) [3], and in patients with chronic obstructive pulmonary disease (COPD) [4] and heart failure [5]. The 6-min walk test (6MWT) is easy to perform and has been standardised [6], and also predicts mortality in COPD [7,8] and in pulmonary hypertension [9].The 6MWT is considered a submaximal test; however, CASAS et al. [10] have shown that patients with COPD walk at a pace close to their maximal exercise capacity while the V9O 2 measured at the end of an incremental protocol in COPD is not a true maximal oxygen uptake [11,12]. This indicates that the differences between tests in the patients with COPD may not be as large as otherwise suspected. There is a modest but significant correlation between V9O 2 and 6-min walking distance (6MWD) [13,14], implying that the tests are not equal; however, as it relates to the capacity to predict survival in COPD, the current authors have recently shown that the 6MWD is equal to, if not better than, V9O 2 at predicting this outcome [15].The BODE index, which incorporates measurements of nutrition (body mass index), airflow obstruction (forced expiratory volume in one second (FEV1)), dyspnoea (Modified Medical Research Council dyspnoea scale) and exercise capacity as measured by the 6MWD,...

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“…First, it was not a randomized controlled trial and there was no control group. However, it is diffi cult to perform a randomized trial with a control group, because although several preoperative physiologic criteria have been reported, 24,25 the standards for deciding pulmonary resection procedures based on such preoperative criteria (including cardiopulmonary function tests) have not yet been established. Second, UPAO was employed for preoperative risk assessment.…”

Section: Discussionmentioning

confidence: 99%

Selection of pulmonary resection procedures to reduce postoperative complications in 200 patients

et al. 2011

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Cardiopulmonary Exercise Testing in the Preoperative Assessment for Lung Resection Surgery

Cited by 44 publications

References 52 publications

Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper

Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper

The modified BODE index: validation with mortality in COPD

Selection of pulmonary resection procedures to reduce postoperative complications in 200 patients

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