J 2023

Prediction of Postoperative Complications: Ventilatory Efficiency and Rest End-tidal Carbon Dioxide

BRAT, Kristián, Pavel HOMOLKA, Zdeněk MERTA, Miloš CHOBOLA, Michaela HEROUTOVA et. al.

Základní údaje

Originální název

Prediction of Postoperative Complications: Ventilatory Efficiency and Rest End-tidal Carbon Dioxide

Autoři

BRAT, Kristián (703 Slovensko, domácí), Pavel HOMOLKA (203 Česká republika), Zdeněk MERTA (203 Česká republika, domácí), Miloš CHOBOLA (203 Česká republika, domácí), Michaela HEROUTOVA (203 Česká republika), Monika BRATOVÁ (203 Česká republika, domácí), Ladislav MITÁŠ (203 Česká republika, domácí), Zdeněk CHOVANEC (203 Česká republika, domácí), Teodor HORVÁTH (203 Česká republika, domácí), Michal BENEJ (203 Česká republika), Jaroslav IVIČIČ (203 Česká republika, domácí), Michal SVOBODA (203 Česká republika, domácí), Vladimír ŠRÁMEK (203 Česká republika, domácí), Lyle J OLSON (840 Spojené státy) a Ivan ČUNDRLE (203 Česká republika, garant, domácí)

Vydání

Annals of Thoracic Surgery, New York, Elsevier Science Inc. 2023, 0003-4975

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30212 Surgery

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 4.600 v roce 2022

Kód RIV

RIV/00216224:14110/23:00131004

Organizační jednotka

Lékařská fakulta

UT WoS

000984808000001

Klíčová slova anglicky

Postoperative Complications; Prediction; Ventilatory Efficiency; Rest End-tidal Carbon Dioxide

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 20. 6. 2023 10:09, Mgr. Tereza Miškechová

Anotace

V originále

BACKGROUND Cardiopulmonary exercise testing parameters including ventilatory efficiency (VE/VCO2 slope) are used for risk assessment of lung resection candidates. However, many patients are unable or unwilling to undergo exercise. VE/VCO2 slope is closely related to the partial pressure of end-tidal carbon dioxide (PETCO2). We hypothesized PETCO2 at rest predicts postoperative pulmonary complications.METHODS Consecutive lung resection candidates were included in this prospective multicenter study. Postoperative respiratory complications were assessed from the first 30 postoperative days or from the hospital stay. Student t test or Mann-Whitney U test was used for comparison. Multivariate stepwise logistic regression analysis was used to analyze association with the development of postoperative pulmonary complications. The De Long test was used to compare area under the curve (AUC). Data are summarized as median (interquartile range).RESULTS Three hundred fifty-three patients were analyzed, of which 59 (17%) developed postoperative pulmonary complications. PETCO2 at rest was significantly lower (27 [24-30] vs 29 [26-32] mm Hg; P < .01) and VE/VCO2 slope during exercise significantly higher (35 [30-40] vs 29 [25-33]; P < .01) in patients who developed postoperative pulmonary complications. Both rest PETCO2 with odds ratio 0.90 (95% confidence interval [CI] 0.83-0.97); P = .01 and VE/VCO2 slope with odds ratio 1.10 (95% CI 1.05-1.16); P < .01 were independently associated with postoperative pulmonary complications by multivariate stepwise logistic regression analysis. There was no significant difference between AUC of both models (rest PETCO2: AUC = 0.79 (95% CI 0.74-0.85); VE/VCO2 slope: AUC = 0.81 (95% CI 0.75-0.86); P = .48).CONCLUSIONS PETCO2 at rest has similar prognostic utility as VE/VCO2 slope, suggesting rest PETCO2 may be used for postoperative pulmonary complications prediction in lung resection candidates.