2025
Causes of ventilatory inefficiency in lung resection candidates.
BARTOŠ, Štěpán; Michal SVOBODA; Kristián BRAT; Marek LUKEŠ; Adam PREDÁČ et. al.Basic information
Original name
Causes of ventilatory inefficiency in lung resection candidates.
Authors
BARTOŠ, Štěpán (203 Czech Republic, belonging to the institution); Michal SVOBODA (203 Czech Republic, belonging to the institution); Kristián BRAT (703 Slovakia, belonging to the institution); Marek LUKEŠ (203 Czech Republic, belonging to the institution); Adam PREDÁČ (703 Slovakia, belonging to the institution); Pavel HOMOLKA (203 Czech Republic, belonging to the institution); Olson LYLE (840 United States of America) and Ivan ČUNDRLE (203 Czech Republic, belonging to the institution)
Edition
ERJ Open Research, SHEFFIELD, EUROPEAN RESPIRATORY SOC JOURNALS LTD, 2025, 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:
Impact factor
Impact factor: 4.300 in 2023
Organization unit
Faculty of Medicine
UT WoS
001477535300001
EID Scopus
2-s2.0-105001867280
Keywords in English
ventilatory inefficiency; lung resection candidates
Tags
International impact, Reviewed
Changed: 3/6/2025 13:37, Mgr. Tereza Miškechová
Abstract
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.