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Cardiopulmonary exercise testing in thoracic surgery

Irina Pele

Irina Pele

“Marius Nasta” Institute of pneumophtisiology, Lung Function Tests DepartmentBucharest, Romania
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Pele, Irina
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Florin-Dumitru Mihălțan

Florin-Dumitru Mihălțan

  • “Marius Nasta” Institute of pneumophtisiologyBucharest, Romania
  • “Carol Davila” Univesity of Medicine and PharmacyBucharest, Romania
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Mihălțan, Florin-Dumitru
  
27 juil. 2020
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Catégorie d'article: General Reviews
Publié en ligne: 27 juil. 2020
Pages: 3 - 10
DOI: https://doi.org/10.2478/pneum-2020-0001
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© 2020 Irina Pele et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Cardiopulmonary exercise test on the cycle ergometer.
Cardiopulmonary exercise test on the cycle ergometer.

Figure 2

The place of CPET in guidelines recommendation according to FEV1, DLCO and their PPO values. ACCP, American College of Chest Physician; BTS, British Thoracic Society; CPET, cardio-pulmonary exercise test; DLCO, diffusing capacity of the lung for carbon monoxide; ERS/ESTS, European Respiratory Society/European Society of Thoracic Surgeons; FEV1, forced expiratory volume in 1 second; PPO, predicted postoperative.
The place of CPET in guidelines recommendation according to FEV1, DLCO and their PPO values. ACCP, American College of Chest Physician; BTS, British Thoracic Society; CPET, cardio-pulmonary exercise test; DLCO, diffusing capacity of the lung for carbon monoxide; ERS/ESTS, European Respiratory Society/European Society of Thoracic Surgeons; FEV1, forced expiratory volume in 1 second; PPO, predicted postoperative.

Figure 3

Design of a HIIT programme (adapted from published data) (55,56). HIIT, high-intensity interval training; WRpeak, peak work rate.
Design of a HIIT programme (adapted from published data) (55,56). HIIT, high-intensity interval training; WRpeak, peak work rate.

Parameters of the CPET with threshold values and their postoperative outcome

ReferenceRisk thresholdOutcome
VO2 peak or VO2 maxBechard et al. 1987 (n = 50) (30)<10 ml/kg/min29% mortality and 43% morbidity (10.7% morbidity if 10 < VO2 max < 20 ml/kg/min; no mortality/morbidity if VO2 >20 ml/kg/min)
Brunelli et al. 2009 (n = 204) (31)<12 ml/kg/min13% mortality and 33% morbidity (no mortality, 3.5% morbidity if VO2 >20 ml/kg/min)
Smith et al. 1984 (n = 22) (32)<15 ml/kg/min100% morbidity
Byram et al. 2007 (n = 55) (33)39% morbidity (no morbidity if VO2 ≥ 15 ml/kg/min)
Bolliger et al. 1995 (n = 80) (35)<60%85.5% probability of complications after resection involving more than one lobe
<43%90% probability of serious complications
Larsen et al. 1997 (n = 97) (36)<50%60% sensitivity of mortality risk
ATGuazzi et al. 2016 (39)<11 ml/kg/minHigh risk of complications (proposed prognostic marker)
VE/VCO2 slopeTorchio et al. 2010 (n = 145) (40)≥345.5% of patients predicted not to survive after surgery (98% of patients predicted to survive if VE/VCO2 <34)
The only independent mortality predictor
Brunelli et al. 2012 (n = 225) (41)>35High risk of respiratory complications (22% vs. 7.6%) and mortality (7.2% vs. 0.6%); comparison with patients with VE/VO2 ≤35
Miyazaki et al. 2018 (n = 974) (44)>4090-day mortality: 16% vs. 5%
2-year mortality: no difference (comparison with patients with VE/VCO2 ≤40)
Langue:
Anglais
Périodicité:
Volume Open
Sujets de la revue:
Médecine, Médecine clinique, Médecine clinique, autres, Médecine interne, Pneumologie
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