Source: International Congress 2014 – Risk assessment and tracheal reconstructions

Abstract

Objective: To identify different factors measured during a cardiopulmonary exercise test (CPET) on a treadmill that might be associated with postoperative cardiopulmonary complications.Methods: In a prospective study, 71 candidates for lung cancer surgery (female=35) underwent CPET on a treadmill. Typical CPET variables were evaluated for associations with postoperative cardiopulmonary complications.Results:Postoperative mortality within 60 days was 4.2% (n=3). They all had abnormal gas-exchange response and the VO_2max range from 16.7 to 29.3 mL·kg^-1·min^-1 (68-76% pred). The cardiopulmonary complications were recorded in 28% (n=20), significantly more frequent in men than in women (85% vs 15%).

CPET variables categorized by those who received complications compared to those who did not

Variables	Uncomplicated	Complicated
FEV1 (% pred)	89.2±24.2	83.3±21.0
DLco (% pred)	81.3±22.4	77.5±16.8
VO2max (mL·kg-1·min-1)	24.2±5.4	22.8±7.0
VO2max mL·kg-1·min-1 % pred (%) *	82.6±15.7	73.5±18.5
VO2max (L·min-1)	1.70±0.47	1.74±0.62
VO2max L·min-1 % pred (%) *	77.8±17.9	67.2±19.1
Anaerobic Threshold % pred (%) **	84.5±21.1	68.1±17.4
VE/VCO2 slope *	28.1±4.8	30.7±4.8
OxygenPulse (mL·beat-1)	11.6±3.4	12.9±3.8
Breathing reserve (%)	34.9±13.9	35.7±15.6

Conclusion: VO_2max in % of predicted seems more suitable than the absolute value (mL·kg^-1·min^-1) for risk stratification prior to lung cancer surgery. This is probably due to gender differences since females in general have significant lower VO_2max compared to the males. In addition, anaerobic threshold and VE/VCO₂ slope should be considered as a marker for risk stratification, especially in those patients who are not able to exercise until exhaustion.
*=p<0.05, **=p<0.01

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Citations should be made in the following way:
E. Edvardsen, S. A. Anderssen, F. Borchsenius, S. Rustad, O. H. Skjønsberg (Oslo, Norway). Cardiopulmonary exercise test and risk stratifications for lung cancer surgery. Eur Respir J 2014; 44: Suppl. 58, 1920

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