HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Lewis Wetstein Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bechard, D. Articles by Wetstein, L. Search for Related Content PubMed PubMed Citation Articles by Bechard, D. Articles by Wetstein, L.

Ann Thorac Surg 1987;44:344-349
© 1987 The Society of Thoracic Surgeons

---

Articles

Assessment of Exercise Oxygen Consumption as Preoperative Criterion for Lung Resection

From the Division of Pulmonary Medicine, Department of Medicine, and the Division of Thoracic and Cardiac Surgery, Medical College of Virginia, Virginia Commonwealth University, and the Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, VA

^* Address reprint requests to Dr. Wetstein, Medical College of Virginia, PO Box 68, MCV Station, Richmond, VA 23298-0001

Determination of preoperative pulmonary function is crucial in avoiding complications from pulmonary resection. Many have employed static pulmonary function testing in an attempt to decrease morbidity and mortality from lung resections. The purpose of the present study was to correlate preoperative static pulmonary function, one-second forced expiratory volume (FEV₁), and exercise O₂ consumption (MVo₂) with postoperative morbidity and mortality. Fifty consecutive patients underwent preoperative FEV₁ and MVo₂ determinations. A criterion for surgical resection included an FEV₁ greater than 1.7 liters for pneumonectomy, greater than 1.2 liters for lobectomy, and greater than 0.9 liters for wedge resection. The surgeon was blinded as to the results of MVo₂ studies. Mean age was 63.8 years (range, 47 to 76 years). There were 10 pneumonectomies, 28 lobectomies, and 12 wedge resections. Among the 50 surgical candidates selected solely on the standard FEV₁ values, mortality was 4% (2/50) and morbidity, 12% (6/50). Stratification on the basis of exercise performance showed a 29% mortality (2/7) and a 43% morbidity (3/7) in patients with an MVo₂ less than 10 ml/kg/min. Patients with an MVo₂ less than 20 but greater than 10 ml/kg/min had a 10.7% morbidity (3/28), and there were no deaths. No patients with an MVo₂ greater than 20 ml/kg/min sustained any morbidity or died (p < 0.001). We conclude that exercise is an important criterion in the preoperative evaluation of patients for pulmonary surgery. An MVo₂ less than 10 ml/kg/min is associated with significant morbidity and mortality.

This article has been cited by other articles:

				E. Lim, M. Beckles, C. Warburton, and D. Baldwin Cardiopulmonary exercise testing for the selection of patients undergoing surgery for lung cancer: friend or foe? Thorax, October 1, 2010; 65(10): 847 - 849. [Full Text] [PDF]

				E. Lim, D. Baldwin, M. Beckles, J. Duffy, J. Entwisle, C. Faivre-Finn, K. Kerr, A. Macfie, J. McGuigan, S. Padley, et al. Guidelines on the radical management of patients with lung cancer Thorax, October 1, 2010; 65(Suppl_3): iii1 - iii27. [Abstract] [Full Text] [PDF]

				A. Brunelli, A. Charloux, C. T. Bolliger, G. Rocco, J-P. Sculier, G. Varela, M. Licker, M. K. Ferguson, C. Faivre-Finn, R. M. Huber, et al. ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy) Eur. Respir. J., July 1, 2009; 34(1): 17 - 41. [Abstract] [Full Text] [PDF]

				A. Bobbio, A. Chetta, E. Internullo, L. Ampollini, P. Carbognani, S. Bettati, M. Rusca, and D. Olivieri Exercise capacity assessment in patients undergoing lung resection Eur J Cardiothorac Surg, March 1, 2009; 35(3): 419 - 422. [Abstract] [Full Text] [PDF]

				W. K. Bernstein and S. Deshpande Preoperative Evaluation for Thoracic Surgery Seminars in Cardiothoracic and Vascular Anesthesia, June 1, 2008; 12(2): 109 - 121. [Abstract] [PDF]

				M. J. Forshaw, D. C. Strauss, A. R. Davies, D. Wilson, B. Lams, A. Pearce, A. J. Botha, and R. C. Mason Is Cardiopulmonary Exercise Testing a Useful Test Before Esophagectomy? Ann. Thorac. Surg., January 1, 2008; 85(1): 294 - 299. [Abstract] [Full Text] [PDF]

				A. Bobbio, A. Chetta, L. Ampollini, G. L. Primomo, E. Internullo, P. Carbognani, M. Rusca, and D. Olivieri Preoperative pulmonary rehabilitation in patients undergoing lung resection for non-small cell lung cancer Eur J Cardiothorac Surg, January 1, 2008; 33(1): 95 - 98. [Abstract] [Full Text] [PDF]

				D. R. Subotic, D. V. Mandaric, T. M. Eminovic, M. M. Gajic, N. M. Mujovic, N. D. Atanasijadis, P. P. Dzeletovic, L. D. Andric, B. M. Bulajic, I. D. Dimitrijevic, et al. Influence of chronic obstructive pulmonary disease on postoperative lung function and complications in patients undergoing operations for primary non-small cell lung cancer. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1292 - 1299. [Abstract] [Full Text] [PDF]

				G. L. Colice, S. Shafazand, J. P. Griffin, R. Keenan, and C. T. Bolliger Physiologic Evaluation of the Patient With Lung Cancer Being Considered for Resectional Surgery: ACCP Evidenced-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 161S - 177S. [Abstract] [Full Text] [PDF]

				J. I. Keddissi and G. T. Kinasewitz The More, the Better: Maximum Oxygen Uptake and Lung Resection Chest, April 1, 2005; 127(4): 1092 - 1094. [Full Text] [PDF]

				T. Win, A. Jackson, L. Sharples, A. M. Groves, F. C. Wells, A. J. Ritchie, and C. M. Laroche Cardiopulmonary Exercise Tests and Lung Cancer Surgical Outcome Chest, April 1, 2005; 127(4): 1159 - 1165. [Abstract] [Full Text] [PDF]

				A. Brunelli, A. Sabbatini, F. Xiume', A. Borri, M. Salati, D. Marasco Rita, and A. Fianchini Inability to perform maximal stair climbing test before lung resection: a propensity score analysis on early outcome Eur J Cardiothorac Surg, March 1, 2005; 27(3): 367 - 372. [Abstract] [Full Text] [PDF]

				H. Matsuoka, W. Nishio, T. Sakamoto, H. Harada, and N. Tsubota Prediction of morbidity after lung resection with risk factors using treadmill exercise test Eur J Cardiothorac Surg, September 1, 2004; 26(3): 480 - 482. [Abstract] [Full Text] [PDF]

				A. Brunelli, M. Monteverde, M. Al Refai, and A. Fianchini Stair climbing test as a predictor of cardiopulmonary complications after pulmonary lobectomy in the elderly Ann. Thorac. Surg., January 1, 2004; 77(1): 266 - 270. [Abstract] [Full Text] [PDF]

				J. R. Burke, I. G. Duarte, V. H. Thourani, and J. I. Miller Jr Preoperative risk assessment for marginal patients requiring pulmonary resection Ann. Thorac. Surg., November 1, 2003; 76(5): 1767 - 1773. [Abstract] [Full Text] [PDF]

				D. Datta and B. Lahiri Preoperative Evaluation of Patients Undergoing Lung Resection Surgery Chest, June 1, 2003; 123(6): 2096 - 2103. [Abstract] [Full Text] [PDF]

				ATS/ACCP Statement on Cardiopulmonary Exercise Testing Am. J. Respir. Crit. Care Med., January 15, 2003; 167(2): 211 - 277. [Full Text] [PDF]

				M. A. Beckles, S. G. Spiro, G. L. Colice, and R. M. Rudd The Physiologic Evaluation of Patients With Lung Cancer Being Considered for Resectional Surgery Chest, January 1, 2003; 123(2009): 105S - 114S. [Abstract] [Full Text] [PDF]

				B. Chenuel, P. Haouzi, P. Olivier, P.Y. Marie, B. Chalon, and J. Borrelly Effect of exercise on lung-perfusion scanning in patients with bronchogenic carcinoma Eur. Respir. J., September 1, 2002; 20(3): 710 - 716. [Abstract] [Full Text] [PDF]

				A. Brunelli, M. Al Refai, M. Monteverde, A. Borri, M. Salati, and A. Fianchini Stair Climbing Test Predicts Cardiopulmonary Complications After Lung Resection* Chest, April 1, 2002; 121(4): 1106 - 1110. [Abstract] [Full Text] [PDF]

				G. T. Kinasewitz and M. H. Welch A Simple Method to Assess Postoperative Risk Chest, October 1, 2001; 120(4): 1057 - 1058. [Full Text] [PDF]

				M. Girish, E. Trayner Jr, O. Dammann, V. Pinto-Plata, and B. Celli Symptom-Limited Stair Climbing as a Predictor of Postoperative Cardiopulmonary Complications After High-Risk Surgery Chest, October 1, 2001; 120(4): 1147 - 1151. [Abstract] [Full Text] [PDF]

				British Thoracic Society, Society of Cardiothoracic Surgeons of Great Britai, and Ireland Working Party Guidelines on the selection of patients with lung cancer for surgery Thorax, February 1, 2001; 56(2): 89 - 108. [Full Text]

				S. Cykert, G. Kissling, and C. J. Hansen Patient Preferences Regarding Possible Outcomes of Lung Resection : What Outcomes Should Preoperative Evaluations Target? Chest, June 1, 2000; 117(6): 1551 - 1559. [Abstract] [Full Text] [PDF]

				J. J. Reilly Jr Evidence-Based Preoperative Evaluation of Candidates for Thoracotomy* Chest, December 1, 1999; 116(2011): 474S - 476S. [Abstract] [Full Text] [PDF]

				J. Wang, J. Olak, R. E. Ultmann, and M. K. Ferguson Assessment of pulmonary complications after lung resection Ann. Thorac. Surg., May 1, 1999; 67(5): 1444 - 1447. [Abstract] [Full Text] [PDF]

				C. WYSER, P. STULZ, M. SOLER, M. TAMM, J. MULLER-BRAND, J. HABICHT, A. P. PERRUCHOUD, and C. T. BOLLIGER Prospective Evaluation of an Algorithm for the Functional Assessment of Lung Resection Candidates Am. J. Respir. Crit. Care Med., May 1, 1999; 159(5): 1450 - 1456. [Abstract] [Full Text] [PDF]

				A. Carretta, P. Zannini, A. Puglisi, G. Chiesa, A. Vanzulli, A. Bianchi, A. Fumagalli, and S. Bianco Improvement of pulmonary function after lobectomy for non-small cell lung cancer in emphysematous patients Eur J Cardiothorac Surg, May 1, 1999; 15(5): 602 - 607. [Abstract] [Full Text] [PDF]

				M. K. Ferguson Preoperative Assessment of Pulmonary Risk Chest, May 1, 1999; 115(2009): 58S - 63S. [Abstract] [Full Text] [PDF]

				A-M Nugent, I C Steele, A M Carragher, K McManus, J A McGuigan, J R P Gibbons, M S Riley, and D P Nicholls Effect of thoracotomy and lung resection on exercise capacity in patients with lung cancer Thorax, April 1, 1999; 54(4): 334 - 338. [Abstract] [Full Text]

				J. A. Melendez and M. E. Fischer Predicting Postoperative Outcome Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 1997; 1(3): 199 - 207. [Abstract] [PDF]

				Pretreatment Evaluation of Non-Small-cell Lung Cancer Am. J. Respir. Crit. Care Med., July 1, 1997; 156(1): 320 - 332. [Full Text]

				L. Wetstein and J. R. Mault Physiologic Evaluation of the Lung Resection Candidate Ann. Thorac. Surg., September 1, 1996; 62(3): 923 - 923. [Full Text]

				M. Okada, M. Okada, N. Ishii, C. Yamashita, T. Sugimoto, K. Okada, H. Yamagishi, T. Yamashita, and H. Matsuda RIGHT VENTRICULAR EJECTION FRACTION IN THE PREOPERATIVE RISK EVALUATION OF CANDIDATES FOR PULMONARY RESECTION J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 364 - 370. [Abstract] [Full Text]

				P. Pate, M. F. Tenholder, J. P. Griffin, C. E. Eastridge, and D. S. Weiman Preoperative Assessment of the High-Risk Patient for Lung Resection Ann. Thorac. Surg., May 1, 1996; 61(5): 1494 - 1500. [Abstract] [Full Text]

				V. Rao, T. R. J. Todd, A. Kuus, K. J. Buth, and F. G. Pearson Exercise oximetry versus spirometry in the assessment of risk prior to lung resection Ann. Thorac. Surg., September 1, 1995; 60(3): 603 - 609. [Abstract] [PDF]

				M. K. Ferguson, L. B. Reeder, and R. Mick Optimizing selection of patients for major lung resection J. Thorac. Cardiovasc. Surg., February 1, 1995; 109(2): 275 - 283. [Abstract] [Full Text]

				A. K. Vaaler, H. O. Hosannah, and R. B. Wagner Pneumonectomy after contralateral lobectomy: Is it reasonable? Ann. Thorac. Surg., January 1, 1995; 59(1): 178 - 183. [Abstract] [PDF]

				G. L. Walsh, R. C. Morice, J. B. Putnam Jr, J. C. Nesbitt, M. J. McMurtrey, M. B. Ryan, J. M. Reising, K. M. Willis, J. D. Morton, and J. A. Roth Resection of lung cancer is justified in high-risk patients selected by exercise oxygen consumption Ann. Thorac. Surg., September 1, 1994; 58(3): 704 - 711. [Abstract] [PDF]

				J. W. Lewis Jr., M. Bastanfar, F. Gabriel, and E. Mascha Right heart function and prediction of respiratory morbidity in patients undergoing pneumonectomy with moderately severe cardiopulmonary dysfunction J. Thorac. Cardiovasc. Surg., July 1, 1994; 108(1): 169 - 175. [Abstract] [Full Text]

				J. B. Putnam Jr, D. E. Lammermeier, R. Colon, M. J. McMurtrey, M. K. Ali, and J. A. Roth Predicted pulmonary function and survival after pneumonectomy for primary lung carcinoma Ann. Thorac. Surg., June 1, 1990; 49(6): 909 - 915. [Abstract] [PDF]

				J. D. Zibrak, C. R. O'Donnell, and K. Marton Indications for Pulmonary Function Testing Ann Intern Med, May 15, 1990; 112(10): 763 - 771. [Abstract] [PDF]

				L. Wetstein Assessment of exercise oxygen consumption: Reply Ann. Thorac. Surg., April 1, 1989; 47(4): 639 - 639. [PDF]

				T. Kalmbach and T. Z. Lajos Retrieval of Metallic Objects from the Pericardial Cavity Ann. Thorac. Surg., October 1, 1988; 46(4): 484 - 484. [PDF]