Preoperative maximal exercise oxygen consumption test predicts postoperative pulmonary morbidity following major lung resection.
OBJECTIVE
Pulmonary resection carries a significant morbidity and mortality. The utility of maximal oxygen uptake test (VO(2)max) to predict cardiopulmonary complications following major pulmonary resection was evaluated.


METHODS
Following standard preoperative work-up and VO(2)max testing, 55 patients (49 male; mean age 59 years, range 20-74) underwent major pulmonary surgery: lobectomy (n = 31), bilobectomy (n = 6) and pneumonectomy (n = 18). An investigator blinded to the preoperative assessment prospectively collected data on postoperative cardiopulmonary complications. Patients were divided into two groups according to preoperative VO(2)max and also according to FEV(1). The frequency of postoperative complications in the groups was compared.


RESULTS
Complications were observed in 19 (34.5%) patients, 11 of which were pulmonary (20%). There were two deaths (3.6%), both due to respiratory failure. Preoperative FEV(1) failed to predict postoperative respiratory complications. Five of 36 patients with a preoperative FEV(1) > 2 L suffered pulmonary complications, compared with six of 19 patients with FEV(1) < 2 L. Cardiopulmonary complications were not observed in patients with VO(2)max > 15 mL/kg/min (n = 27); however, 11 patients with VO(2)max < 15 mL/kg/min (n = 28) suffered cardiopulmonary complications (P < 0.05).


CONCLUSIONS
VO(2)max predicts postoperative pulmonary complications following major lung resection, and the risk of complications increases significantly when the preoperative VO(2)max is less than 15 mL/kg/min.
Bayram
Ahmet Sami
AS
Medical Faculty, Department of Thoracic Surgery, Uludag University, Bursa, Turkey. asbayram2@yahoo.com
Candan
Tarik
T
Gebitekin
Cengiz
C
D000328:Adult; D000368:Aged; D005541:Forced Expiratory Volume; D006801:Humans; D008875:Middle Aged; D009017:Morbidity; D010101:Oxygen Consumption; D011013:Pneumonectomy / Q000009:adverse effects; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies