[Pre-operative screening tests for lung cancer using the analysis of expired gas with exercise testing--principally VO2 max/m2].
The analysis of expired gas with exercise testing was conducted preoperatively with lung cancer patients in order to examine the relationship between maximum oxygen consumption (VO2 max) and postoperative complications, determining the cut-off of VO2 max/m2. The usefulness of the test as a preoperative screening test for both pulmonary ventilation and circulation was evaluated in comparison to pulmonary ventilation tests with spirometry and pulmonary circulation tests with Swan-Ganz catheter. Preoperative VO2 max/m2 was calculated from VO2 max in 111 patients with lung cancer who underwent lobectomy of more than one lobe. Also preoperatively conducted were pulmonary ventilation tests by spirometry and pulmonary circulation tests using the Swan-Ganz catheter to measure VC, %VC, FEV1.0, FEV1.0%, mean pulmonary arterial pressure (PPA) and cardiac output coefficient (C.I.). Form theses measurements, VC/m2, FEV1.0/m2 and total pulmonary vascular resistance (TPVR) were calculated. After the cut-off values of VO2 max/m2 were set tentatively at three stages, 600, 650 and 700 ml/min/m2 based on the incidence of postoperative complications, the 111 patients were divided into two groups in each cut-off value; one with VO2 max/m2 greater than the cut-off value and the other less than the cut-off value. Comparison of measurements obtained by spirometry between the two groups disclosed significant differences (p < 0.001) in VC/m2, %VC and FEV1.0/m2 in all cut-off values. Similarly, comparison of measurements obtained using the Swan-Ganz catheter between the two groups yielded significant differences (p < 0.05 to p < 0.01) in PPA and TPVR in all cut-off values.(ABSTRACT TRUNCATED AT 250 WORDS)
Nagamatsu
Y
Y
First Department of Surgery Kurume University School of Medicine, Japan.
Ono
H
H
Hiraki
H
H
Matsuo
T
T
Mitsuoka
M
M
Takamori
S
S
Hayashi
A
A
Yamana
H
H
Hayashida
R
R
Kakegawa
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002407:Catheterization, Swan-Ganz; D005080:Exercise Test; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011652:Pulmonary Circulation; D012129:Respiratory Function Tests / Q000379:methods*; D013147:Spirometry; D014692:Ventilation-Perfusion Ratio