[Value of sophisticated explorative techniques of the pulmonary function in the preoperative evaluation of respiratory risk].
In order to estimate the preoperative evaluation of the respiratory risk, a well adapted clinical examination associated with a routine pulmonary function test (VC, FEV1) can be sufficient. Although some patients with cardiopulmonary disorders or candidates to lung resection need more complex assessments: the flow-volume loop to detect small airways obstruction (MEF 50%, MEF 25%), measure of bronchial hyperreactivity to predict bronchospasm during anaesthesia, residual volume for the diagnosis of emphysema, diffusing capacity (DCO) to discover lung fibrosis: these parameters disruption always make the pronostic worse. It is also useful to couple together preoperative function test and pulmonary scintigraphy to predict post-operative values after lung resection. But, these criteria for operability are not always a good indicator of post-operative complications. So it is possible to use in addition the results of exercise testing to determine cardio-respiratory performances and maximal oxygen consumption (VO2MAX) which seem better correlated with mortality and post-operative lung surgical complications. Preliminary results of our study concerning thirty patients hospitalized in Besancon-St-Jacques Hospital, agree with the hypothesis that exercise testing is an important criterion in the pre-operative evaluation and to predict post-operative mortality and morbidity of patients candidates to thoracic surgery.
Simon-Rigaud
M L
ML
Service de physiopathologie respiratoire-médecine du sport, Centre hospitalier et universitaire St-Jacques, Besançon.
Kantelip
J P
JP
Clement
F
F
Levy
P
P
Depierre
A
A
Magnin
P
P
D006801:Humans; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods*; D012119:Respiration; D012129:Respiratory Function Tests; D012306:Risk
Intérêt des techniques sophistiquées d'exploration fonctionnelle pulmonaire dans l'évaluation préopératoire du risque respiratoire.