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

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.

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

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

Abstract

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.

Citovat

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.

@article{2292750,
   author = {Brat, Kristián and Homolka, Pavel and Merta, Zdeněk and Chobola, Miloš and Heroutova, Michaela and Bratová, Monika and Mitáš, Ladislav and Chovanec, Zdeněk and Horváth, Teodor and Benej, Michal and Ivičič, Jaroslav and Svoboda, Michal and Šrámek, Vladimír and Olson, Lyle J and Čundrle, Ivan},
   article_location = {New York},
   article_number = {5},
   doi = {http://dx.doi.org/10.1016/j.athoracsur.2021.11.073},
   keywords = {Postoperative Complications; Prediction; Ventilatory Efficiency; Rest End-tidal Carbon Dioxide},
   language = {eng},
   issn = {0003-4975},
   journal = {Annals of Thoracic Surgery},
   title = {Prediction of Postoperative Complications: Ventilatory Efficiency and Rest End-tidal Carbon Dioxide},
   url = {https://www.sciencedirect.com/science/article/pii/S0003497522000601},
   volume = {115},
   year = {2023}
}

TY  - JOUR
ID  - 2292750
AU  - Brat, Kristián - Homolka, Pavel - Merta, Zdeněk - Chobola, Miloš - Heroutova, Michaela - Bratová, Monika - Mitáš, Ladislav - Chovanec, Zdeněk - Horváth, Teodor - Benej, Michal - Ivičič, Jaroslav - Svoboda, Michal - Šrámek, Vladimír - Olson, Lyle J - Čundrle, Ivan
PY  - 2023
TI  - Prediction of Postoperative Complications: Ventilatory Efficiency and Rest End-tidal Carbon Dioxide
JF  - Annals of Thoracic Surgery
VL  - 115
IS  - 5
SP  - 1305-1311
EP  - 1305-1311
PB  - Elsevier Science Inc.
SN  - 00034975
KW  - Postoperative Complications
KW  - Prediction
KW  - Ventilatory Efficiency
KW  - Rest End-tidal Carbon Dioxide
UR  - https://www.sciencedirect.com/science/article/pii/S0003497522000601
N2  - 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.
ER  -

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. \textit{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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