J 2023

The risk of post-operative pulmonary complications in lung resection candidates with normal forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide: a prospective multicentre study

ČUNDRLE, Ivan, Zdeněk MERTA, Monika BRATOVÁ, Pavel HOMOLKA, Ladislav MITÁŠ et. al.

Základní údaje

Originální název

The risk of post-operative pulmonary complications in lung resection candidates with normal forced expiratory volume in 1 s and diffusing capacity of the lung for carbon monoxide: a prospective multicentre study

Autoři

ČUNDRLE, Ivan (203 Česká republika, domácí), Zdeněk MERTA (203 Česká republika, domácí), Monika BRATOVÁ (203 Česká republika, domácí), Pavel HOMOLKA (203 Česká republika), Ladislav MITÁŠ (203 Česká republika, domácí), Vladimír ŠRÁMEK (203 Česká republika, domácí), Michal SVOBODA (203 Česká republika, domácí), Zdeněk CHOVANEC (203 Česká republika, domácí), Miloš CHOBOLA (203 Česká republika, domácí), Lyle J. OLSON a Kristián BRAT (703 Slovensko, garant, domácí)

Vydání

ERJ open research, SHEFFIELD, EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2023, 2312-0541

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30203 Respiratory systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 4.600 v roce 2022

Kód RIV

RIV/00216224:14110/23:00130703

Organizační jednotka

Lékařská fakulta

UT WoS

000947843200012

Klíčová slova anglicky

lung resection; post-operative pulmonary complications; carbon monoxide

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 19. 2. 2024 08:43, Mgr. Tereza Miškechová

Anotace

V originále

Introduction According to the guidelines for preoperative assessment of lung resection candidates, patients with normal forced expiratory volume in 1 s (FEV1) and diffusing capacity of the lung for carbon monoxide (DLCO) are at low risk for post-operative pulmonary complications (PPC). However, PPC affect hospital length of stay and related healthcare costs. We aimed to assess risk of PPC for lung resection candidates with normal FEV1 and D-LCO (>80% predicted) and identify factors associated with PPC. Methods 398 patients were prospectively studied at two centres between 2017 and 2021. PPC were recorded from the first 30 post-operative days. Subgroups of patients with and without PPC were compared and factors with significant difference were analysed by uni- and multivariate logistic regression. Results 188 subjects had normal FEV1 and D-LCO. Of these, 17 patients (9%) developed PPC. Patients with PPC had significantly lower pressure of end-tidal carbon dioxide (P-ETCO2) at rest (27.7 versus 29.9; p=0.033) and higher ventilatory efficiency (V'(E)/V'(CO2)) slope (31.1 versus 28; p=0.016) compared to those without PPC. Multivariate models showed association between resting P-ETCO2 (OR 0.872; p=0.035) and V'(E)/V'(CO2) slope (OR 1.116; p=0.03) and PPC. In both models, thoracotomy was strongly associated with PPC (OR 6.419; p=0.005 and OR 5.884; p=0.007, respectively). Peak oxygen consumption failed to predict PPC ( p=0.917). Conclusions Resting P-ETCO2 adds incremental information for risk prediction of PPC in patients with normal FEV1 and D-LCO. We propose resting P-ETCO2 be an additional parameter to FEV1 and D-LCO for preoperative risk stratification.