BRAT, Kristián, Pavel HOMOLKA, Zdeněk MERTA, Miloš CHOBOLA, Michaela HEROUTOVA, Monika BRATOVÁ, Ladislav MITÁŠ, Zdeněk CHOVANEC, Teodor HORVÁTH, Michal BENEJ, Jaroslav IVIČIČ, Michal SVOBODA, Vladimír ŠRÁMEK, Lyle J OLSON and Ivan ČUNDRLE. Prediction of Postoperative Complications: Ventilatory Efficiency and Rest End-tidal Carbon Dioxide. Annals of Thoracic Surgery. New York: Elsevier Science Inc., 2023, vol. 115, No 5, p. 1305-1311. ISSN 0003-4975. Available from: https://dx.doi.org/10.1016/j.athoracsur.2021.11.073.
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Basic information
Original name Prediction of Postoperative Complications: Ventilatory Efficiency and Rest End-tidal Carbon Dioxide
Authors BRAT, Kristián (703 Slovakia, belonging to the institution), Pavel HOMOLKA (203 Czech Republic), Zdeněk MERTA (203 Czech Republic, belonging to the institution), Miloš CHOBOLA (203 Czech Republic, belonging to the institution), Michaela HEROUTOVA (203 Czech Republic), Monika BRATOVÁ (203 Czech Republic, belonging to the institution), Ladislav MITÁŠ (203 Czech Republic, belonging to the institution), Zdeněk CHOVANEC (203 Czech Republic, belonging to the institution), Teodor HORVÁTH (203 Czech Republic, belonging to the institution), Michal BENEJ (203 Czech Republic), Jaroslav IVIČIČ (203 Czech Republic, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution), Vladimír ŠRÁMEK (203 Czech Republic, belonging to the institution), Lyle J OLSON (840 United States of America) and Ivan ČUNDRLE (203 Czech Republic, guarantor, belonging to the institution).
Edition Annals of Thoracic Surgery, New York, Elsevier Science Inc. 2023, 0003-4975.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30212 Surgery
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 4.600 in 2022
RIV identification code RIV/00216224:14110/23:00131004
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.athoracsur.2021.11.073
UT WoS 000984808000001
Keywords in English Postoperative Complications; Prediction; Ventilatory Efficiency; Rest End-tidal Carbon Dioxide
Tags 14110120, 14110122, 14110215, 14110223, 14119612, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 20/6/2023 10:09.
Abstract
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.
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