Predictors of exercise oxygen desaturation following major lung resection.
OBJECTIVE
To identify predictors of postoperative exercise oxygen desaturation (EOD) in patients submitted to lobectomy or pneumonectomy for lung carcinoma.


METHODS
A consecutive series of 227 patients with non-small cell lung cancer submitted to lobectomy or pneumonectomy from January 2000 through October 2002 were prospectively analyzed. Maximal stair-climbing tests were performed preoperatively (the day before the operation) and postoperatively (on average, 9.2 days after operation) in room air for all patients. A fall in oxygen saturation during the exercise below 90% was termed 'desaturation'. Univariate and multivariate analyses were performed to identify predictors of postoperative EOD.


RESULTS
Thirty-five patients (15.4%) developed postoperative EOD. After multivariate analysis, the only independent predictor of postoperative EOD resulted a reduction in oxygen saturation during the preoperative exercise (P=0.0004).


CONCLUSIONS
Patients with a reduction in oxygen saturation during the preoperative exercise test are at increased risk to develop a postoperative EOD below 90%. A postoperative exercise test should be performed in all these patients. Should EOD be confirmed, an intermittent home oxygen therapy is recommended in order to facilitate recovery from operation and improve the quality of life.
Brunelli
Alessandro
A
Unit of Thoracic Surgery, Department of Respiratory Diseases, Umberto I Hospital, Ancona, Italy. alexit_2000@yahoo.com
Al Refai
Majed
M
Monteverde
Marco
M
Borri
Alessandro
A
Salati
Michele
M
Fianchini
Aroldo
A
D000368:Aged; D000704:Analysis of Variance; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000601:surgery* / Q000628:therapy; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008175:Lung Neoplasms / Q000097:blood / Q000601:surgery* / Q000628:therapy; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D010102:Oxygen Inhalation Therapy; D011013:Pneumonectomy; D011184:Postoperative Period; D011446:Prospective Studies; D013147:Spirometry; D014057:Tomography, X-Ray Computed
D010100:Oxygen