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

Licker, Marc; Schnyder, J-M; Frey, J-G; Diaper, J; Cartier, V; Inan, Cigdem; Robert, John; Bridevaux, Pierre-Olivier; Tschopp, Jean-Marie

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Title		Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery
Authors		Licker, Marc Schnyder, J-M Frey, J-G Diaper, J Cartier, V Inan, Cigdem Robert, John Bridevaux, Pierre-Olivier Tschopp, Jean-Marie show all authors [1 - 9]
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/mortality — Adenocarcinoma/mortality/surgery — Adult — Aged — Aging — Arrhythmias, Cardiac/etiology/mortality — Bronchopneumonia/mortality — Cohort Studies — Exercise/physiology — Female — Heart Failure/etiology/mortality — Humans — Hypertension/complications/physiopathology — Incidence — Lung Neoplasms/mortality/surgery — Male — Middle Aged — Myocardial Infarction/etiology/mortality — Oxygen Consumption/physiology — Physical Endurance/physiology — Postoperative Complications/etiology/physiopathology — Pulmonary Atelectasis/etiology/mortality — Retrospective Studies — Risk Factors
Identifiers		DOI: 10.1183/09031936.00069910 PMID: 20847073
Full text		Article (Published version) (392 Kb) - Free access
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine interne des spécialités Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie et soins intensifs
Research groups		Dysfonctions cardio-pulmonaires et cérébrales (278) Chirurgie thoracique et chirurgie endocrinologique (573)
Citation (ISO format)		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