Exercise testing for pre-operative evaluation

Harvie, David A.; Levett, Denny

doi:10.1183/2312508x.10012117

Cited by 8 publications

(11 citation statements)

References 151 publications

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“…2) Preoperative evaluation (e.g. lung resection surgery, surgical and bronchoscopic lung volume reduction, lung and heart-lung transplantation) [5]. CPET is a relatively safe procedure [36] with a rate of death for patients between two and five per 100 000 clinical exercise tests [11].…”

Section: Exercise Testingmentioning

confidence: 99%

“…Cardiopulmonary exercise testing (CPET) is useful in the assessment of subjects with chronic lung conditions as it may help to: 1) recognise physiological factors limiting exercise (with or without the presence of psychogenic limiting factors); 2) identify these factors as potential therapeutic targets; 3) allow quantification of the level of impairment; 4) assess the effects of an intervention; and 5) provide prognostic information [1][2][3][4][5][6][7]. Furthermore, CPET is a common procedure in research.…”

Section: Introductionmentioning

confidence: 99%

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ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

et al. 2019

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The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.

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Section: Exercise Testingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

et al. 2019

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“…Reliable preoperative risk stratification is an essential component informing perioperative decision‐making and must be based on accurate patient information and assessment 1 . Issues of inaccurate and incomplete patient information during phone screening can have serious implications for patient safety during perioperative procedures, and it can be particularly challenging to accurately screen institutionalized residents (ie, patients who are imprisoned or who reside in long‐term care facilities) over the phone.…”

mentioning

confidence: 99%

Preoperative Screening of Institutionalized Residents: A Practice Change

Lyons¹,

Mangum²,

Allen³

2020

AORN Journal

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“…In the pre-operative assessment of lung resection surgery, some more recent reports described a role for high V′E-V′CO 2 indices in the prediction of a negative outcome in patients with intermediate peak V′O 2 values [64,65]; HARVIE and LEVETT [66] provide a chapter on pre-operative evaluation (including lung transplantation) later in this Monograph. The value of traditional variables previously found to be useful in the pre-operative assessment of major abdominal surgery (low peak V′O 2 and/or V′O 2 ΘT) has been extended to colorectal, hepatobiliary, urological and abdominal aortic aneurysm surgery (as recently reviewed in [67,68]).…”

Section: Pre-operative Assessmentmentioning

confidence: 99%

“…Limitations in pre-operative assessment Peak V′O 2 is still widely used in practice for risk estimation at pre-operative assessment (as discussed in a chapter on pre-surgical evaluation later in this Monograph [66]). However, this is an effort-dependent variable that is influenced by peripheral factors (detraining, muscle weakness), particularly in lung cancer patients (who frequently present with associated COPD).…”

Section: Risk Assessmentmentioning

confidence: 99%

Preface

Bals¹

Clinical Exercise Testing

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CPET is one of the most useful and informative diagnostic approaches in pulmonary medicine. It offers deep insight into the cardiopulmonary network and generates data that can be used in diagnosis, staging and outcome prediction in multiple lung diseases. In the hands of an experienced investigator, exercise testing looks easy and elegant. For the patient, exercise testing focuses on relevant outcomes, such as exercise capacity and dyspnoea. It also has the benefit of being noninvasive. However, for novices in this area, the large amount of information generated and the task of interpreting this data can cause a sense of reluctance. The data that result from exercise testing differ in complexity, ranging from simple one-figure measurements to graphical displays of time curves requiring sophisticated interpretation of. As a result, a comprehensive summary of the methodology of CPET is urgently needed to ensure its more frequent use in clinical practice. This ERS Monograph is therefore timely as it provides the reader with a broad and detailed overview of the various CPET applications. The initial chapters summarise the technologies and standard techniques used. They are followed by sections about individual disease areas and a chapter on lung transplantation. Self-assessment cases have also been included in this book, a first for the ERS Monograph book series. We hope that our readers like this new feature and will find it useful. The Guest Editors Paolo Palange, Pierantonio Laveneziana, J. Alberto Neder and Susan A. Ward have worked very hard on topic selection and to integrate these aspects into a book that summarises current knowledge. Together with the authors, they have produced a practice-guideline publication that comprises both background information and hands-on application. I am sure this comprehensive review will be useful in the clinical practice of a broad range of respiratory physicians, and will improve patient care.

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Exercise testing for pre-operative evaluation

Cited by 8 publications

References 151 publications

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

Preoperative Screening of Institutionalized Residents: A Practice Change

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