Standardized exercise oximetry predicts postpneumonectomy outcome

Ninan, Mathew; Sommers, K. Eric; Landreneau, Rodney J.; Weyant, Robert J.; Tobias, John W.; Luketich, James D.; Ferson, Peter F.; Keenan, Robert J.

doi:10.1016/s0003-4975(97)00474-8

Cited by 83 publications

(46 citation statements)

References 10 publications

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“…In particular, those patients climbing less than 12 m and developing EOD had a mortality rate as high as 29%. These findings confirm a previous investigation from Ninan and coll [28] who found that an exercise oxygen desaturation of 4% or greater in a standardised stair-stepper apparatus predicted longer intensive care unit stay and incidence of major cardiopulmonary morbidity. An older study from Rao and colleagues [27] found that exercise oximetry measured during a 150 m walk around the ward predicted better than spirometry home oxygen re- …”

Section: Stair Climbingsupporting

confidence: 91%

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Low-technology exercise test in the preoperative evaluation of lung resection candidates

Brunelli¹,

Pompili²,

Salati³

2016

Monaldi Arch Chest Dis

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Exercise tests are increasingly used in the preoperative functional evaluation of lung resection candidates. Low-technology exercise tests include six minute walking, shuttle walking and stair climbing. Conflicting evidence has been reported regarding 6 minute walking test. This test should not be used to select patients for lung resection. An incremental shuttle walk test is easier to replicate than 6 minute walking test. Most patients achieving 25 shuttles or 400 m have a maximum oxygen consumption measured at cardiopulmonary exercise test greater than 15 l/Kg/min. Although this test tends to underestimate performance at the lower range compared to peak oxygen consumption it can be used a screening test before lung resection. Excluding patients from operation based on this test alone is however not recommended and a formal cardiopulmonary exercise test should be always used in those walking less than 400 m. Stair climbing has been extensively studied in thoracic surgery. Several studies have found that poor performance in this test is indicative of cardiopulmonary complications and mortality after lung resection. In particular, climbing less than 12 m represents very high risk, whereas climbing more than 22 m is associated with a favourable outcome. Recent guidelines recommend referring all patients climbing lower than 22 m to cardiopulmonary exercise test. Stair climbing can be used as a screening test in cases cardiopulmonary exercise test is not readily available. In general, patients climbing more than 22 m can proceed to surgery without further evaluation.

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Section: Stair Climbingsupporting

confidence: 91%

“…Nevertheless, controversy still exists on the best definition (< 90% or greater than 4%), and its association with postoperative complications [27][28][29][30].…”

Section: Stair Climbingmentioning

confidence: 99%

Low-technology exercise test in the preoperative evaluation of lung resection candidates

Brunelli¹,

Pompili²,

Salati³

2016

Monaldi Arch Chest Dis

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“…Although exercise oximetry has been proposed to be a useful tool in the pre-operative functional evaluation of lung resection candidates [33,34], the role of exercise oxygen desaturation (EOD) in risk stratification has not been defined regarding its definition and its association with early outcome after lung resection [126][127][128].…”

Section: Exercise Tests Exercise Tests: Systematic or Selective?mentioning

confidence: 99%

“…Two studies [126,127] found that EOD was a better discriminant of post-operative respiratory failure, need for intensive care unit (ICU) admission, prolonged hospital stay and home oxygen requirement with respect to spirometry. However, VARELA et al [128] found that oxygen desaturation ,90% during standardised incremental cycle ergometry was not a significant predictor of post-operative cardiopulmonary morbidity.…”

Section: Exercise Tests Exercise Tests: Systematic or Selective?mentioning

confidence: 99%

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

Eur Respir J

766

550

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A collaboration of multidisciplinary experts on the functional evaluation of lung cancer patients has been facilitated by the European Respiratory Society (ERS) and the European Society of Thoracic Surgery (ESTS), in order to draw up recommendations and provide clinicians with clear, up-to-date guidelines on fitness for surgery and chemo-radiotherapy.The subject was divided into different topics, which were then assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. The draft reports written by the experts on each topic were reviewed, discussed and voted on by the entire expert panel. The evidence supporting each recommendation was summarised, and graded as described by the Scottish Intercollegiate Guidelines Network Grading Review Group. Clinical practice guidelines were generated and finalised in a functional algorithm for risk stratification of the lung resection candidates, emphasising cardiological evaluation, forced expiratory volume in 1 s, systematic carbon monoxide lung diffusion capacity and exercise testing.Contrary to lung resection, for which the scientific evidences are more robust, we were unable to recommend any specific test, cut-off value, or algorithm before chemo-radiotherapy due to the lack of data. We recommend that lung cancer patients should be managed in specialised settings by multidisciplinary teams.

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“…The role of oxygen desaturation during the exercise in postoperative risk stratification has not been defined in relation to early complications after the resection. In addition, it has been seen that oxygen desaturation during the exercise is a good predictor of postoperative respiratory failure, need for admission to an Intensive Care Unit (ICU), prolonged hospital stays and home treatment with oxygen (Ninan et al, 1997). On the other hand, oxygen saturation below 90% during the exercise test with incremental protocol is not a good predictor of postoperative cardiopulmonary morbidity (Varela et al, 2001).…”

Section: Low-technology Exercise; Stair Climbing Shuttle Walk and 6mentioning

confidence: 99%

Perioperative Pulmonary Functional Assessment

Álvarez¹,

Romero²,

Rodríguez³

2012

Front Lines of Thoracic Surgery

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Standardized exercise oximetry predicts postpneumonectomy outcome

Cited by 83 publications

References 10 publications

Low-technology exercise test in the preoperative evaluation of lung resection candidates

Low-technology exercise test in the preoperative evaluation of lung resection candidates

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Perioperative Pulmonary Functional Assessment

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