Minute ventilation-to-carbon dioxide output (VE/VCO2) slope is the strongest predictor of respiratory complications and death after pulmonary resection

The Annals of Thoracic Surgery
Alessandro BrunelliArmando Sabbatini

Abstract

This study assessed whether the minute ventilation-to-carbon dioxide output (VE/VCO2) slope, a measure of ventilatory efficiency routinely measured during cardiopulmonary exercise testing (CPET), is an independent predictor of respiratory complications after major lung resections. Prospective observational analysis was performed on 225 consecutive candidates after lobectomy (197 patients) or pneumonectomy (28 patients) from 2008 to 2010. Inoperability criteria were peak oxygen consumption (VO2) of less than 10 mL/kg/min in association with predicted postoperative forced expiratory volume in 1 second of less than 30% and diffusion capacity of the lung for carbon monoxide of less than 30%. All patients performed a symptom-limited CPET on cycle ergometer. Respiratory complications (30 days or in-hospital) were prospectively recorded: pneumonia, atelectasis requiring bronchoscopy, respiratory failure on mechanical ventilation exceeding 48 hours, adult respiratory distress syndrome, pulmonary edema, and pulmonary embolism. Univariable and multivariable regression analyses were used to identify independent predictors of respiratory complications. Cardiopulmonary morbidity and mortality rates were 23% (51 patients) and 2.2% (5 patient...Continue Reading

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Citations

Apr 10, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hanaa ShafiekBorja G Cosío
Apr 15, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alessandro Brunelli
Jul 2, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marco ChiappettaFrancesco Facciolo
Oct 13, 2016·Current Surgery Reports·Michele Salati, Alessandro Brunelli
Mar 21, 2017·Revista Portuguesa De Cardiologia : Orgão Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology·Plínio S Ramos, Claudio Gil S Araújo
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Mar 10, 2017·The European Respiratory Journal·J Alberto NederDenis E O'Donnell
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Dec 1, 2020·International Anesthesiology Clinics·Paul S Richman, Deborah C Richman
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Sep 5, 2020·Surgical Oncology Clinics of North America·Alessandro BrunelliCecilia Pompili
Apr 16, 2019·The Journal of Thoracic and Cardiovascular Surgery·Francis-Edouard GravierDavid Debeaumont
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Sep 17, 2021·European Respiratory Review : an Official Journal of the European Respiratory Society·J Alberto NederDenis E O'Donnell

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