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Ann Thorac Surg 1987;44:487-490
© 1987 The Society of Thoracic Surgeons

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Articles

Exercise Tolerance Test in Lung Cancer Patients: The Relationship between Exercise Capacity and Postthoracotomy Hospital Mortality

From the First Department of Surgery, Osaka University Medical School, and the Second Department of Surgery, Tokushima University Medical School, Osaka, Japan

Accepted for publication March 11, 1987.

^* Address reprint requests to Dr. Miyoshi, First Department of Surgery, Osaka University School of Medicine, Fukushima-ku, Osaka, 553, Japan

To evaluate the significance of the blood lactate threshold as a predictor of postthoracotomy hospital mortality resulting from pulmonary complications, a 3-minute incremental exercise test was administered to 33 lung cancer patients who underwent thoracotomy between October, 1981, and May, 1984. The oxygen consumption/body surface area at an arterial lactate level of 20 mg/dl (V·O₂/BSA at La-20) was adopted as the blood lactate threshold. Age and pulmonary function parameters such as forced expiratory volume in one second (FEV₁/body surface area (BSA), FEV₁/forced vital capacity, diffusing capacity for the carbon monoxide/lung volume, and maximum ventilatory volume/BSA revealed significant differences between patients with postthoracotomy pulmonary complications and those without such complications. However, there was no difference in pulmonary function test results between the surviving and deceased patients. In contrast, although V·O₂/BSA at La-20 did not differ between the patients with and without pulmonary complications, it differed significantly between the surviving and deceased patients.

We concluded that postthoracotomy pulmonary complications depended on the severity of preoperatively associated pulmonary function disorders and that the blood lactate threshold expressed by V·O₂/BSA at La-20 was an important indicator of the risk of hospital mortality.

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