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Graded exercise testing and postthoracotomy complications.

P G Boysen1, C A Clark, A J Block

  • 1Department of Anesthesiology, University of Florida College of Medicine, J. Hillis Miller Health Center, Gainesville 32610-0254.

Journal of Cardiothoracic Anesthesia
|February 1, 1990
PubMed
Summary
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Preoperative exercise testing in lung disease patients undergoing thoracotomy did not reliably predict complications. Maximal oxygen consumption (VO2max) and ventilation (VE max) showed no significant link to adverse outcomes, suggesting exercise limitation alone shouldn't exclude surgical candidates.

Area of Science:

  • Pulmonary Medicine
  • Cardiopulmonary Physiology
  • Thoracic Surgery

Background:

  • Preoperative assessment for thoracotomy in patients with lung disease is crucial for predicting outcomes.
  • The role of exercise testing in identifying patients at risk for postthoracotomy complications remains controversial.

Purpose of the Study:

  • To evaluate the predictive value of a presurgical exercise protocol for postthoracotomy complications in patients with lung disease.
  • To differentiate between cardiac and pulmonary exercise limitation in this patient group.

Main Methods:

  • Seventy patients with lung disease underwent pulmonary function tests and perfusion studies.
  • Seventeen patients completed a maximal treadmill exercise tolerance test measuring VO2max and VE max.
  • Breathing and heart rate reserves were calculated to assess exercise limitation.

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Main Results:

  • No significant relationship was found between VO2max, VE max, or O2 pulse and cardiopulmonary complications.
  • Predicted VE max and maximum heart rate showed a correlation with total complications, but not specifically cardiopulmonary ones.
  • Two patients experienced cardiopulmonary complications; six had noncardiopulmonary complications.

Conclusions:

  • Maximal exercise testing is difficult to perform in patients with chronic lung disease undergoing thoracotomy.
  • Exercise limitation alone is not a feasible criterion for excluding patients from surgical consideration based on these findings.