J 2025

Causes of ventilatory inefficiency in lung resection candidates.

BARTOŠ, Štěpán; Michal SVOBODA; Kristián BRAT; Marek LUKEŠ; Adam PREDÁČ et. al.

Základní údaje

Originální název

Causes of ventilatory inefficiency in lung resection candidates.

Autoři

BARTOŠ, Štěpán (203 Česká republika, domácí); Michal SVOBODA (203 Česká republika, domácí); Kristián BRAT (703 Slovensko, domácí); Marek LUKEŠ (203 Česká republika, domácí); Adam PREDÁČ (703 Slovensko, domácí); Pavel HOMOLKA (203 Česká republika, domácí); Olson LYLE (840 Spojené státy) a Ivan ČUNDRLE (203 Česká republika, domácí)

Vydání

ERJ Open Research, SHEFFIELD, EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2025, 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: 4.300 v roce 2023

Organizační jednotka

Lékařská fakulta

UT WoS

001477535300001

EID Scopus

2-s2.0-105001867280

Klíčová slova anglicky

ventilatory inefficiency; lung resection candidates

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 3. 6. 2025 13:37, Mgr. Tereza Miškechová

Anotace

V originále

Introduction Ventilatory efficiency (V′E/V′CO2) has been shown to predict postoperative pulmonary complications (PPCs) in lung resection candidates. V′E/V′CO2 is determined by arterial partial pressure of carbon dioxide (PaCO2) and by dead space to tidal volume ratio (VD/VT). We hypothesised PaCO2 and VD/VT contribute equally to the increase in V′E/V′CO2 in lung resection patients. Methods Consecutive lung resection candidates from two prior prospective studies were included in this post hoc analysis. All subjects underwent preoperative spirometry, cardiopulmonary exercise testing and arterial blood gas analysis at rest and peak exercise. PPCs were prospectively assessed during the first 30 postoperative days, or hospital stay. A t-test, Mann–Whitney U-test and two-tailed Fisher's exact test were used to compare patients with and without PPCs. p-values <0.05 were considered statistically significant. Results Of 398 patients, PPC developed in 64 (16%). Patients with PPCs more frequently underwent lobectomy by open thoracotomy, had longer hospital and ICU length of stay and higher 30- and 90-day mortality. Moreover, patients with PPCs exhibited a higher V′E/V′CO2 ratio both at rest and peak exercise. Both ratios were independently associated with PPCs. At rest, the contribution of PaCO2 and VD/VT to the increase in V′E/V′CO2 ratio in patients with PPCs was 45% and 55%, respectively. At peak exercise, the contribution of PaCO2 and VD/VT to the increase in V′E/V′CO2 ratio was 16% and 84%, respectively. Conclusions VD/VT (V′/Q′ mismatch and/or rapid shallow breathing pattern) is the dominant contributor to the increase in V′E/V′CO2 in lung resection candidates who develop PPCs.