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@article{1637636, author = {Brat, Kristián and Chobola, Miloš and Homolka, Pavel and Heroutová, Michaela and Benej, Michal and Mitáš, Ladislav and Olson, Lyle J. and Čundrle, Ivan}, article_location = {OXFORD}, article_number = {2}, doi = {http://dx.doi.org/10.1093/icvts/ivz255}, keywords = {V-E/VCO2 slope; Prolonged air leak; Postoperative complications; Anatomical lung resection}, language = {eng}, issn = {1569-9293}, journal = {Interactive CardioVascular and Thoracic Surgery}, title = {Poor ventilatory efficiency during exercise may predict prolonged air leak after pulmonary lobectomy}, url = {http://dx.doi.org/10.1093/icvts/ivz255}, volume = {30}, year = {2020} }
TY - JOUR ID - 1637636 AU - Brat, Kristián - Chobola, Miloš - Homolka, Pavel - Heroutová, Michaela - Benej, Michal - Mitáš, Ladislav - Olson, Lyle J. - Čundrle, Ivan PY - 2020 TI - Poor ventilatory efficiency during exercise may predict prolonged air leak after pulmonary lobectomy JF - Interactive CardioVascular and Thoracic Surgery VL - 30 IS - 2 SP - 269-272 EP - 269-272 PB - OXFORD UNIV PRESS SN - 15699293 KW - V-E/VCO2 slope KW - Prolonged air leak KW - Postoperative complications KW - Anatomical lung resection UR - http://dx.doi.org/10.1093/icvts/ivz255 L2 - http://dx.doi.org/10.1093/icvts/ivz255 N2 - 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. ER -
BRAT, Kristián, Miloš CHOBOLA, Pavel HOMOLKA, Michaela HEROUTOVÁ, Michal BENEJ, Ladislav MITÁŠ, Lyle J. OLSON and Ivan ČUNDRLE. Poor ventilatory efficiency during exercise may predict prolonged air leak after pulmonary lobectomy. \textit{Interactive CardioVascular and Thoracic Surgery}. OXFORD: OXFORD UNIV PRESS, 2020, vol.~30, No~2, p.~269-272. ISSN~1569-9293. Available from: https://dx.doi.org/10.1093/icvts/ivz255.
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