title: Predicted versus observed maximum oxygen consumption early after lung resection.
abstract: BACKGROUND
  The objective of this study was to identify the predictors of underestimation and overestimation of postoperative maximum oxygen consumption (VO(2)max).
  
  
  METHODS
  A prospective analysis was performed on 229 patients who had 38 pneumonectomies, 171 lobectomies, and 20 segmentectomies. All patients performed a preoperative and postoperative (on average 9.2 days after surgery) maximal stair-climbing test. Predicted postoperative VO(2)max (ppoVO(2)max) was calculated on the basis of the number of functioning segments removed during operation. The patients were divided into three groups: group A (158 cases), patients with a ppoVO(2)max within 1 standard deviation of the observed postoperative VO(2)max; group B (56 cases), patients with a difference between the observed postoperative VO(2)max and ppoVO(2)max greater than 1 standard deviation (underestimation); and group C (15 cases), patients with a difference between ppoVO(2)max and the observed postoperative VO(2)max greater than 1 standard deviation (overestimation). Univariate and multivariate analyses were performed.
  
  
  RESULTS
  The only significant predictor of underestimation was a high percentage of functional parenchyma removed during operation (p < 0.0001). The significant predictors of overestimation were a low percentage of functional parenchyma removed during operation (p = 0.01) and a high preoperative VO(2)max (p = 0.002).
  
  
  CONCLUSIONS
  The prediction of postoperative VO(2)max was not accurate in all patients. Those with a large amount of functional lung tissue removed during operation tended to have a postoperative VO(2)max greater than expected. Conversely, those patients with a small amount of functional lung tissue resected tended to have a postoperative VO(2)max lower than predicted.
authors.affiliation: Department of Thoracic Surgery, Umberto I, Regional Hospital, Ancona, Italy. alexit_2000@yahoo.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Brunelli
authors.forename: Marco
authors.initials: M
authors.lastname: Monteverde
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borri
authors.forename: Michele
authors.initials: M
authors.lastname: Salati
authors.forename: Majed
authors.initials: M
authors.lastname: Al Refai
authors.forename: Aroldo
authors.initials: A
authors.lastname: Fianchini
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D011013:Pneumonectomy / Q000379:methods*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011653:Pulmonary Diffusing Capacity / Q000502:physiology*; D011659:Pulmonary Gas Exchange; D012129:Respiratory Function Tests; D016896:Treatment Outcome