Preoperative pulmonary evaluation of the thoracic surgical patient.
Fig. 2 is an algorithm for the preoperative pulmonary evaluation of the lung resection candidate. Patients should undergo routine spirometry and diffusion capacity testing. If the FEV1 and DLCO are greater than 80% predicted, no further study is needed. When these parameters are less than 80%, some estimation of postoperative function is likely needed, taking into account the proposed resection. Patients with ppoFEV1 or ppoDLCO less than 40% are at increased risk of perioperative complications or death and should undergo formal exercise testing. A VO2max or ppoVO2max less than 10 mL/kg/min is associated with prohibitive risk for anatomic lung resection, and alternative treatment modalities should be considered.
Section of General Thoracic Surgery, Division of Cardiothoracic Surgery, University of Colorado Health Sciences Center, 4200 East 9th Avenue, C-310, Denver, CO 80262, USA.
Aditya K
AK
Kaza
John D
JD
Mitchell
D000465:Algorithms; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000601:surgery*; D003948:Diagnostic Techniques, Respiratory System; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011013:Pneumonectomy; D011300:Preoperative Care; D018570:Risk Assessment