Exercise ventilatory inefficiency and mortality in patients with chronic obstructive pulmonary disease undergoing surgery for non-small-cell lung cancer

Torchio, Roberto; Guglielmo, Marco; Giardino, Roberto; Ardissone, Francesco; Ciacco, Claudio; Gulotta, Carlo; Veljković, Aleksandar; Bugiani, Massimiliano

doi:10.1016/j.ejcts.2010.01.032

Cited by 88 publications

(92 citation statements)

References 25 publications

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“…The main results of this study may be summarized as follows: i) V' O2peak with V' E /V' CO2 slope, as previously reported [7,8], are good predictors of occurrence of severe postoperative cardiopulmonary complications after lung resection in patients considered operable after a preoperative study including CPET; ii) an high V' E /V' CO2 slope can be considered an independent postoperative mortality predictor only before pneumonectomy; iii) no deaths occurred when the V' E /V' CO2 slope was in the normal range.…”

Section: Discussionmentioning

confidence: 63%

Minute ventilation to carbon dioxide output (V’E/V’CO2 slope) is the strongest death predictor before larger lung resections

Torchio¹,

Mazzucco²,

Guglielmo³

et al. 2017

Monaldi Arch Chest Dis

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The minute ventilation to carbon dioxide (CO 2 ) production ratio (V' E /V' CO2 slope) was recently identified as a mortality predictor after lung surgery, but the effect of the resection extent was not taken into account. The aim of this study was to investigate the role of V' E /V' CO2 slope as preoperative mortality predictor depending on the type of surgery performed. Retrospective analysis was performed on 263 consecutive patients evaluated before surgery for lung cancer. Death within 30 days and serious respiratory complications were considered. Univariate and multivariate regression analyses were used to identify independent predictors of death. Lobectomy or bilobectomy were performed in 186 patients with 29/186 (15.6%) serious pulmonary complications and 6/186 (3.2%) deaths. Pneumonectomy was performed in 77 patients with 14/77 (18.2%) serious complications and 5/77 (6.5%) deaths. Considering the whole group, the peak oxygen consumption (V' O2peak, L/min; z=-2.66, p<0.008, OR 0.007) and V' E /V' CO2 slope (z=2.80, p<0.005, OR 1.14) were independent predictors of mortality whereas in pneumonectomies V' E /V' CO2 slope (z=2.34, p<0.02, OR 1.22) was the only independent predictor of mortality. High V' E /V' CO2 slope, age and low V' O2peak are predictors of death and severe complications after lung surgery. Before larger resections as pneumonectomies an increased V' E /V' CO2 slope represents the best mortality predictor.

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Section: Discussionmentioning

confidence: 63%

Minute ventilation to carbon dioxide output (V’E/V’CO2 slope) is the strongest death predictor before larger lung resections

Torchio¹,

Mazzucco²,

Guglielmo³

et al. 2017

Monaldi Arch Chest Dis

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show abstract

“…In order to evaluate complication risk, cancer surgeons often assess VO 2peak to determine preoperative physiologic status of operable candidates. VO 2peak is strongly inversely associated with surgical complication rate in NSCLC patients [38][39][40][41]. Further, we found that VO 2peak is also a strong independent predictor of long-term overall survival in NSCLC even after controlling for traditional prognostic factors [42••].…”

Section: Exercise Therapy Prior To Surgical Resectionmentioning

confidence: 93%

Erratum to: Exercise Therapy in the Management of Solid Tumors

Jones

Peppercorn

Scott

et al. 2010

Curr. Treat. Options in Oncol.

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“…In particular a VE/VCO 2 slope greater than 34 was associated with increased risk of pulmonary complications and mortality after lung resection independent of VO 2 max (53,54,56).…”

Section: Cardiopulmonary Exercise Test (Cpet)mentioning

confidence: 99%

“…In addition to VO 2 max, several authors have published about other derived parameters (i.e., efficiency slope, oxygen pulse, VE/VCO 2 slope), which proved to be predictive of cardiac and pulmonary complications (53)(54)(55)(56). In particular a VE/VCO 2 slope greater than 34 was associated with increased risk of pulmonary complications and mortality after lung resection independent of VO 2 max (53,54,56).…”

Section: Cardiopulmonary Exercise Test (Cpet)mentioning

confidence: 99%

Preoperative functional workup for patients with advanced lung cancer

Brunelli

2016

J. Thorac. Dis.

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Locally advanced lung cancer remains a surgical indication in selected patients. This condition often demands larger resections. As a consequence preoperative functional workup is of paramount importance to stratify the risk and choose the most appropriate treatment. We reviewed the current evidence on functional evaluation with a special focus on specific aspects related to locally advanced lung cancer stages (i.e., risk after neoadjuvant treatment, pneumonectomy). Evidence is discussed to provide information that could assist clinicians in their preoperative workup of these challenging patients.

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Exercise ventilatory inefficiency and mortality in patients with chronic obstructive pulmonary disease undergoing surgery for non-small-cell lung cancer

Cited by 88 publications

References 25 publications

Minute ventilation to carbon dioxide output (V’E/V’CO2 slope) is the strongest death predictor before larger lung resections

Minute ventilation to carbon dioxide output (V’E/V’CO2 slope) is the strongest death predictor before larger lung resections

Erratum to: Exercise Therapy in the Management of Solid Tumors

Preoperative functional workup for patients with advanced lung cancer

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