Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery

Licker, M; Schnyder, J-M; Frey, J-G; Diaper, J; Cartier, V; Inan, C; Robert, J; Bridevaux, P-O; Tschopp, J-M (2011). Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery. European respiratory journal, 37(5), pp. 1189-98. Sheffield, UK: European Respiratory Society 10.1183/09031936.00069910

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Over the past decades, major progress in patient selection, surgical techniques and anaesthetic management have largely contributed to improved outcome in lung cancer surgery. The purpose of this study was to identify predictors of post-operative cardiopulmonary morbidity in patients with a forced expiratory volume in 1 s <80% predicted, who underwent cardiopulmonary exercise testing (CPET). In this observational study, 210 consecutive patients with lung cancer underwent CPET with completed data over a 9-yr period (2001-2009). Cardiopulmonary complications occurred in 46 (22%) patients, including four (1.9%) deaths. On logistic regression analysis, peak oxygen uptake (peak V'(O₂) and anaesthesia duration were independent risk factors of both cardiovascular and pulmonary complications; age and the extent of lung resection were additional predictors of cardiovascular complications, whereas tidal volume during one-lung ventilation was a predictor of pulmonary complications. Compared with patients with peak V'(O₂) >17 mL·kg⁻¹·min⁻¹, those with a peak V'(O₂) <10 mL·kg⁻¹·min⁻¹ had a four-fold higher incidence of cardiac and pulmonary morbidity. Our data support the use of pre-operative CPET and the application of an intra-operative protective ventilation strategy. Further studies should evaluate whether pre-operative physical training can improve post-operative outcome.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
UniBE Contributor:	Robert, Jens
ISSN:	0903-1936
Publisher:	European Respiratory Society
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:23
Last Modified:	05 Dec 2022 14:06
Publisher DOI:	10.1183/09031936.00069910
PubMed ID:	20847073
Web of Science ID:	000290089200029
URI:	https://boris.unibe.ch/id/eprint/8107 (FactScience: 213589)