The assessment of cardiopulmonary function in thoracic surgery

Cardiopulmonary function is a determinant of the utmost importance in thoracic surgery. A large battery of tests is available, however, only a relatively limited part of it is obligatory. The essential procedures include testing of global ventilation (inspiratory vital capacity, FEV1), relation of lung volumes (residual volume) and regional quantitation of perfusion (scan). Other costly and invasive tests can be regarded as complementary. This is true in planned lung resection for cancer, where the indication for surgery is of vital importance. Other types of thoracic surgery need a more precise evaluation of risk factors balanced against the expected general improvement of cardiopulmonary function, as in cardiac surgery, decortication, and resection of bullae. But since thoracic surgery is practised mainly for the purpose of lung resection with ensuing loss of function, major attention is paid to this field in order to avoid inconclusive but costly testing, and to discuss indication and use of involved technique in high-risk patients.