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

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.

Basic information

Original name

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

Authors

ČUNDRLE, Ivan (203 Czech Republic, belonging to the institution); Zdeněk MERTA (203 Czech Republic, belonging to the institution); Monika BRATOVÁ (203 Czech Republic, belonging to the institution); Pavel HOMOLKA (203 Czech Republic); Ladislav MITÁŠ (203 Czech Republic, belonging to the institution); Vladimír ŠRÁMEK (203 Czech Republic, belonging to the institution); Michal SVOBODA (203 Czech Republic, belonging to the institution); Zdeněk CHOVANEC (203 Czech Republic, belonging to the institution); Miloš CHOBOLA (203 Czech Republic, belonging to the institution); Lyle J. OLSON and Kristián BRAT (703 Slovakia, guarantor, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30203 Respiratory systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 4.300

RIV identification code

RIV/00216224:14110/23:00130703

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1183/23120541.00421-2022

UT WoS

000947843200012

EID Scopus

2-s2.0-85150225230

Keywords in English

lung resection; post-operative pulmonary complications; carbon monoxide

Abstract

In the original language

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.

Cite

ČUNDRLE, Ivan; Zdeněk MERTA; Monika BRATOVÁ; Pavel HOMOLKA; Ladislav MITÁŠ; Vladimír ŠRÁMEK; Michal SVOBODA; Zdeněk CHOVANEC; Miloš CHOBOLA; Lyle J. OLSON and Kristián BRAT. 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. ERJ open research. SHEFFIELD: EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2023, vol. 9, No 2, p. 1-9. ISSN 2312-0541. Available from: https://dx.doi.org/10.1183/23120541.00421-2022.

@article{2279497,
   author = {Čundrle, Ivan and Merta, Zdeněk and Bratová, Monika and Homolka, Pavel and Mitáš, Ladislav and Šrámek, Vladimír and Svoboda, Michal and Chovanec, Zdeněk and Chobola, Miloš and Olson, Lyle J. and Brat, Kristián},
   article_location = {SHEFFIELD},
   article_number = {2},
   doi = {http://dx.doi.org/10.1183/23120541.00421-2022},
   keywords = {lung resection; post-operative pulmonary complications; carbon monoxide},
   language = {eng},
   issn = {2312-0541},
   journal = {ERJ open research},
   title = {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},
   url = {https://openres.ersjournals.com/content/9/2/00421-2022},
   volume = {9},
   year = {2023}
}

TY  - JOUR
ID  - 2279497
AU  - Čundrle, Ivan - Merta, Zdeněk - Bratová, Monika - Homolka, Pavel - Mitáš, Ladislav - Šrámek, Vladimír - Svoboda, Michal - Chovanec, Zdeněk - Chobola, Miloš - Olson, Lyle J. - Brat, Kristián
PY  - 2023
TI  - 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
JF  - ERJ open research
VL  - 9
IS  - 2
SP  - 1-9
EP  - 1-9
PB  - EUROPEAN RESPIRATORY SOC JOURNALS LTD
SN  - 23120541
KW  - lung resection
KW  - post-operative pulmonary complications
KW  - carbon monoxide
UR  - https://openres.ersjournals.com/content/9/2/00421-2022
N2  - 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.
ER  -

ČUNDRLE, Ivan; Zdeněk MERTA; Monika BRATOVÁ; Pavel HOMOLKA; Ladislav MITÁŠ; Vladimír ŠRÁMEK; Michal SVOBODA; Zdeněk CHOVANEC; Miloš CHOBOLA; Lyle J. OLSON and Kristián BRAT. 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. \textit{ERJ open research}. SHEFFIELD: EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2023, vol.~9, No~2, p.~1-9. ISSN~2312-0541. Available from: https://dx.doi.org/10.1183/23120541.00421-2022.

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