Preoperative cardiopulmonary exercise testing: Determining the limit to exercise and predicting outcome after thoracotomy

Fishman, Robert S.; Systrom, David M.

doi:10.1016/1053-0770(91)90019-p

Cited by 6 publications

(5 citation statements)

References 127 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the thorax has an elastic structure that expands and contracts during breathing, and interaction between the lung and the chest cavity is a crucial parameter representing the gas exchange ability of the lung 9 ) . Further, the expansion and contraction of the lungs are affected by the capacity of the thorax, which is determined by the mobility of the skeletal muscles, the elasticity of surrounding soft tissues, and the intensity of the respiratory muscles 10 ) . Research results have shown that tidal volume is more affected by movement of the rib cage than abdominal motion 11 ) .…”

Section: Discussionmentioning

confidence: 99%

The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness

2015

View full text Add to dashboard Cite

[Purpose] The aim of this study was to examine the effect of chest expansion resistance exercises (CERE) on chest expansion, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) in elderly people with inspiratory muscle weakness. [Subjects] Thirty elderly people with inspiratory muscle weakness (MIP < 80% of the predicted value) were randomly and equally assigned to a chest expansion resistance exercise (CERE) group, core conditioning exercise (CCE) group, and control group. [Methods] The intervention was applied to the CERE group and CCE group five times per week, 30 minutes each time, for six weeks. A tapeline was used to measure upper and lower chest expansion. MIP and MEP before and after the intervention were measured and compared. [Results] There was significant improvement in upper and lower chest expansion and MIP after the intervention in both the CERE group and the CCE group, whereas the control group did not show any significant difference. MEP did not significantly change in any of the three groups after the intervention. [Conclusion] The CERE group underwent greater changes than the CCE group, which proves that the CERE is more effective for improving elderly people’s chest expansion capacity and MIP in elderly people. Therefore, application of the CERE by therapists is recommended if the environment and conditions are appropriate for enhancement of chest expansion capacity and MIP in elderly people.

show abstract

Section: Discussionmentioning

confidence: 99%

The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness

2015

View full text Add to dashboard Cite

show abstract

“…BRI at LT was initially modeled as a linear variable, but threshold effects were found to be equally predictive. A threshold value of 0.70 was subsequently chosen because it represents the value associated with a pulmonary mechanical limit (12,(20)(21)(22). Univariate predictors of moderate statistical significance (p values р 0.25) and those of historical significance (age, BMI, and sex) were included in the initial multivariate model.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, one additional speculation for the increased mortality in patients with an elevated BRI at LT is that these patients have a decreased capability to clear secretions adequately caused by failure of pulmonary mechanics. We have chosen a threshold level for BRI at LT of 0.70 to match reference definitions for a pulmonary mechanical limit (12,(20)(21)(22). The BRI at LT was dichotomized using this definition in the univariate and multivariate analyses performed.…”

Section: Discussionmentioning

confidence: 99%

An Elevated Breathing Reserve Index at the Lactate Threshold Is a Predictor of Mortality in Patients with Cystic Fibrosis Awaiting Lung Transplantation

Tantisira

Systrom

Ginns

2002

Am J Respir Crit Care Med

Self Cite

View full text Add to dashboard Cite

The proportion of cystic fibrosis (CF) patients dying while on the lung transplant wait list remains high; identification of such patients remains difficult. The breathing reserve index (BRI = minute ventilation/maximal voluntary ventilation) at the lactate threshold (LT) is a predictor of a pulmonary mechanical limit to incremental exercise. We hypothesized that an elevated BRI at the LT in patients with CF awaiting lung transplantation would be a predictor of wait list mortality. Forty-five consecutive patients with CF completed cardiopulmonary exercise testing as part of their pretransplant assessment. We evaluated BRI at LT, baseline demographic characteristics, pulmonary function, and other exercise parameters via Cox proportional hazards modeling. Fifteen patients died while awaiting transplant. Twenty one were transplanted, and nine still awaited transplantation. Relative risks from the multivariate model included (95% confidence interval in parentheses) BRI at LT, 17.52 (2.45-123.97); resting Pa(CO(2)), 1.29 (1.10-1.49); resting Pa(O(2)), 0.97 (0.90-1.05); and forced expiratory volume at one second as a percent of predicted, 1.19 (1.05-1.34). BRI at LT not only provided the highest point estimate of risk for wait list mortality but also identified a physiologically significant threshold value (0.70 or more) for those at risk. This measurement may allow improved timing of listing for transplantation, including consideration for living donor transplantation.

show abstract

“…Assessment of peak exercise capacity relies on measurement of oxygen uptake (VO 2peak , measured in liters per minute), reflecting the peak or maximal ability to take in, transport, and use oxygen. VO 2peak has become the gold standard measurement of cardiopulmonary fitness, and is the most important parameter measured during functional exercise testing [51,52]. A normal VO 2peak usually excludes significant pulmonary, cardiovascular, and neuromuscular diseases [51,52].…”

Section: A Practical Application: Preoperative Cardiopulmonary Evaluamentioning

confidence: 99%

Heart Rate Recovery as a Preoperative Test of Perioperative Complication Risk

Fuster

Ries

et al. 2015

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

The autonomic nervous system plays important physiologic roles in a variety of organ systems. Autonomic dysfunction has been shown to be predictive of increased mortality in patients with cardiovascular disease. Its importance in patients with chronic respiratory disorders has been described in recent years. Here, we summarize the prognostic value of autonomic dysfunction, as reflected by impaired heart rate recovery (HRR), in patients with chronic respiratory disorders, including chronic obstructive pulmonary disease, interstitial lung disease, and lung cancer. We suggest that HRR may be clinically useful in the preoperative physiologic evaluation, specifically in lung cancer patients being considered for surgery.

show abstract

Preoperative cardiopulmonary exercise testing: Determining the limit to exercise and predicting outcome after thoracotomy

Cited by 6 publications

References 127 publications

The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness

The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness

An Elevated Breathing Reserve Index at the Lactate Threshold Is a Predictor of Mortality in Patients with Cystic Fibrosis Awaiting Lung Transplantation

Heart Rate Recovery as a Preoperative Test of Perioperative Complication Risk

Contact Info

Product

Resources

About