Impact of Integrative Cardiopulmonary Exercise Testing (12)
Because the increased metabolic and hemodynamic demands of surgery may be viewed as similar to the increased demands of exercise, integrative cardiopulmonary exercise testing has been suggested to improve preoperative evaluation. In a study of 22 patients scheduled for elective thoracotomy for lung cancer, Smith et al found that 11 patients had postoperative complications such as respiratory failure, myocardial infarction, arrhythmia requiring treatment, lobar atelectasis, pulmonary embolism, or death. When these 11 patients were compared with those without complications, it was found that the group with complications did not have a different mean age or resting pulmonary function. buy ventolin inhalers
However, those with complications had a significantly lower mean maximum Vo2. In fact, using a value for maximum Vo2 during cycle exercise of less than 20 ml/min/kg would have 91 percent sensitivity and 83 percent specificity for postoperative complications as defined by the authors with positive and negative predictive values of 83 percent and 90 percent, respectively. Recently, Be-chard and Wetstein found that the two deaths and the majority of postoperative complications found in 50 patients undergoing thoracotomy were among those with a maximum Vo2 less than 10 ml/min/kg.