J 2020

Poor ventilatory efficiency during exercise may predict prolonged air leak after pulmonary lobectomy

BRAT, Kristián, Miloš CHOBOLA, Pavel HOMOLKA, Michaela HEROUTOVÁ, Michal BENEJ et. al.

Basic information

Original name

Poor ventilatory efficiency during exercise may predict prolonged air leak after pulmonary lobectomy

Authors

BRAT, Kristián (703 Slovakia, belonging to the institution), Miloš CHOBOLA (203 Czech Republic, belonging to the institution), Pavel HOMOLKA (203 Czech Republic, belonging to the institution), Michaela HEROUTOVÁ (203 Czech Republic), Michal BENEJ (703 Slovakia, belonging to the institution), Ladislav MITÁŠ (203 Czech Republic, belonging to the institution), Lyle J. OLSON (840 United States of America) and Ivan ČUNDRLE (203 Czech Republic, belonging to the institution)

Edition

Interactive CardioVascular and Thoracic Surgery, OXFORD, OXFORD UNIV PRESS, 2020, 1569-9293

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 1.905

RIV identification code

RIV/00216224:14110/20:00115432

Organization unit

Faculty of Medicine

DOI

UT WoS

000517789800011

Keywords in English

V-E/VCO2 slope; Prolonged air leak; Postoperative complications; Anatomical lung resection

Tags

Tags

International impact, Reviewed
Změněno: 20/3/2020 10:14, Mgr. Tereza Miškechová

Abstract

V originále

Poor ventilatory efficiency, defined as the increase in minute ventilation relative to carbon dioxide production during exercise (V-E/VCO2 slope), may be associated with dynamic hyperinflation and thereby promote the development of prolonged air leak (PAL) after lung resection. Consecutive lung lobectomy candidates (n = 96) were recruited for this prospective two-centre study. All subjects underwent pulmonary function tests and cardiopulmonary exercise testing prior to surgery. PAL was defined as the presence of air leaks from the chest tube on the 5th postoperative day and developed in 28 (29%) subjects. Subjects with PAL were not different in terms of age, sex, American Society of Anesthesiologists class, type of surgery (thoracotomy/video-assisted thoracoscopic surgery) and site of surgery (right/left lung; upper/lower lobes). Subjects with PAL had more frequent pleural adhesions (50% vs 21%; P = 0.006) and steeper V-E/VCO2 slope (35 +/- 7 vs 30 +/- 5; P = 0.001). Stepwise logistic regression showed that only the presence of pleural adhesions [odds ratio (OR) 3.9, 95% confidence interval (CI) 1.4-10.9; P = 0.008] and V-E/VCO2 slope (OR 1.1, 95% CI 1.0-1.2; P = 0.003) were independently associated with PAL (AUC 0.74, 95% CI 0.62-0.86). We conclude that a high V-E/VCO2 slope during exercise may be helpful in identifying patients at greater risk for the development of PAL after lung lobectomy.