J 2022

Ventilatory efficiency is superior to peak oxygen uptake for prediction of lung resection cardiovascular complications

MAZÚR, Andrej, Kristián BRAT, Pavel HOMOLKA, Zdeněk MERTA, Michal SVOBODA et. al.

Basic information

Original name

Ventilatory efficiency is superior to peak oxygen uptake for prediction of lung resection cardiovascular complications

Authors

MAZÚR, Andrej (703 Slovakia, belonging to the institution), Kristián BRAT (703 Slovakia, belonging to the institution), Pavel HOMOLKA (203 Czech Republic, belonging to the institution), Zdeněk MERTA (203 Czech Republic, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution), Monika BRATOVÁ (203 Czech Republic, belonging to the institution), Vladimír ŠRÁMEK (203 Czech Republic, belonging to the institution), Lyle OLSON and Ivan ČUNDRLE (203 Czech Republic, guarantor, belonging to the institution)

Edition

PLoS ONE, SAN FRANCISCO, PUBLIC LIBRARY SCIENCE, 2022, 1932-6203

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 3.700

RIV identification code

RIV/00216224:14110/22:00127257

Organization unit

Faculty of Medicine

DOI

UT WoS

000944132200052

Keywords in English

ventilatory efficiency; cardiovascular complications; peak oxygen consumption

Tags

Tags

International impact, Reviewed
Změněno: 23/3/2023 09:45, Mgr. Tereza Miškechová

Abstract

V originále

Introduction Ventilatory efficiency (VE/VCO2 slope) has been shown superior to peak oxygen consumption (VO2) for prediction of post-operative pulmonary complications in patients undergoing thoracotomy. VE/VCO2 slope is determined by ventilatory drive and ventilation/perfusion mismatch whereas VO2 is related to cardiac output and arteriovenous oxygen difference. We hypothesized pre-operative VO2 predicts post-operative cardiovascular complications in patients undergoing lung resection. Methods Lung resection candidates from a published study were evaluated by post-hoc analysis. All of the patients underwent preoperative cardiopulmonary exercise testing. Post-operative cardiovascular complications were assessed during the first 30 post-operative days or hospital stay. One-way analysis of variance or the Kruskal–Wallis test, and multivariate logistic regression were used for statistical analysis and data summarized as median (IQR). Results Of 353 subjects, 30 (9%) developed pulmonary complications only (excluded from further analysis), while 78 subjects (22%) developed cardiovascular complications and were divided into two groups for analysis: cardiovascular only (n = 49) and cardiovascular with pulmonary complications (n = 29). Compared to patients without complications (n = 245), peak VO2 was significantly lower in the cardiovascular with pulmonary complications group [19.9 ml/kg/min (16.5–25) vs. 16.3 ml/kg/min (15–20.3); P<0.01] but not in the cardiovascular only complications group [19.9 ml/kg/min (16.5–25) vs 19.0 ml/kg/min (16–23.1); P = 0.18]. In contrast, VE/VCO2 slope was significantly higher in both cardiovascular only [29 (25–33) vs. 31 (27–37); P = 0.05] and cardiovascular with pulmonary complication groups [29 (25–33) vs. 37 (34–42); P<0.01)]. Logistic regression analysis showed VE/VCO2 slope [OR = 1.06; 95%CI (1.01–1.11); P = 0.01; AUC = 0.74], but not peak VO2 to be independently associated with post-operative cardiovascular complications. Conclusion VE/VCO2 slope is superior to peak VO2 for prediction of post-operative cardiovascular complications in lung resection candidates.