Predicted Postoperative Product and Diffusion Heterogeneity Index in the Evaluation of Candidates for Lung Resection
| Autor: | Raja T. Abboud, Brian L. Graham, Jeng-Shing Wang |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Spirometry medicine.medical_specialty Lung Neoplasms Critical Care and Intensive Care Medicine Postoperative Complications Predictive Value of Tests Risk Factors DLCO Diffusing capacity Internal medicine Humans Medicine Pneumonectomy Lung cancer Retrospective Studies Chi-Square Distribution Lung medicine.diagnostic_test business.industry Patient Selection VO2 max Retrospective cohort study General Medicine Middle Aged respiratory system medicine.disease Respiratory Function Tests Logistic Models medicine.anatomical_structure ROC Curve Anesthesia Cardiology Pulmonary Diffusing Capacity Female Lung resection business |
| Zdroj: | Respiratory Care. 56:449-455 |
| ISSN: | 1943-3654 0020-1324 |
| Popis: | OBJECTIVES: The primary objective of this retrospective study was to evaluate whether abnormal predicted postoperative variables and predicted postoperative product are useful in predicting postoperative complications. The secondary objective was to assess whether an abnormal diffusion heterogeneity index is associated with increased postoperative complications. METHODS: In this retrospective study we evaluated the medical records of 57 patients who underwent lung resection for lung cancer. Calculations of the predicted postoperative variables were done using preoperative testing data, including the extent of the resected lung segments. Predicted postoperative product was obtained by multiplying the predicted postoperative percent-of-predicted FEV 1 by the predicted postoperative percent-of-predicted single-breath diffusing capacity of the lung for carbon monoxide (DLCO). The measured product was obtained by multiplying FEV1 by DLCO. We derived diffusion heterogeneity index from measurements of the single-breath DLCO with the 3-equation method, as a measure of the heterogeneity of the distribution of gas exchange in the lung. RESULTS: Patients with complications had lower predicted postoperative FEV1 (P < .001), lower predicted postoperative DLCO (P < .001), lower predicted postoperative maximal oxygen uptake (P < .001), lower predicted postoperative increase in percent-of-predicted DLCO at 70% work load from at-rest percent-of-predicted DLCO (DLCO%) (P < .001), lower predicted postoperative product (P < .001), and lower measured product (P .004). Interestingly, diffusion heterogeneity index increased with exercise in all patients with complications but decreased with exercise in all patients without complications. CONCLUSIONS: The predicted postoperative variables, predicted postoperative product, measured product, and diffusion heterogeneity index are potentially useful predictors of complications in candidates for lung resection. Key words: diffusing capacity; exercise testing; lung resection; predicted postoperative product; preoperative evaluation; spirometry. [Respir Care 2011;56(4):449–455. © 2011 Daedalus Enterprises] |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|