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.
Kaza
Aditya K
AK
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.
Mitchell
John D
JD
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