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

Schnyder, J-M
Frey, J-G
Diaper, J
Cartier, V
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Published in European Respiratory Journal. 2011, vol. 37, no. 5, p. 1189-98
Abstract 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.
Keywords Acute Lung Injury/mortalityAdenocarcinoma/mortality/surgeryAdultAgedAgingArrhythmias, Cardiac/etiology/mortalityBronchopneumonia/mortalityCohort StudiesExercise/physiologyFemaleHeart Failure/etiology/mortalityHumansHypertension/complications/physiopathologyIncidenceLung Neoplasms/mortality/surgeryMaleMiddle AgedMyocardial Infarction/etiology/mortalityOxygen Consumption/physiologyPhysical Endurance/physiologyPostoperative Complications/etiology/physiopathologyPulmonary Atelectasis/etiology/mortalityRetrospective StudiesRisk Factors
PMID: 20847073
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Article (Published version) (392 Kb) - public document Free access
Research groups Dysfonctions cardio-pulmonaires et cérébrales (278)
Chirurgie thoracique et chirurgie endocrinologique (573)
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LICKER, Marc et al. Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery. In: European Respiratory Journal, 2011, vol. 37, n° 5, p. 1189-98. https://archive-ouverte.unige.ch/unige:32750

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Deposited on : 2014-01-02

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