Document Detail


Risk assessment for pulmonary resection.
MedLine Citation:
PMID:  20813311     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Risk assessment for pulmonary resection must include a preliminary cardiac evaluation. Patients deemed at prohibitive cardiac risk should be evaluated and treated as per American Heart Association/American Society of Cardiology guidelines. Those with low cardiac risk or with optimized treatment can proceed with pulmonary assessment. A systematic measurement of lung carbon monoxide diffusing capacity is recommended. In addition, predicted postoperative forced expiratory volume in 1 second should not be used alone for patient selection because it is not an accurate predictor of complications, particularly in patients with chronic obstructive pulmonary disease. The use of exercise testing should be emphasized. Low-technology tests, such as stair climbing, can be used whenever a formal cardiopulmonary exercise test is not readily available. However, in case of suboptimal performance (ie, <22 m in the stair-climbing test) patients should be referred to cardiopulmonary exercise testing with measurement of Vo(2max) for a better definition of their aerobic reserve. A Vo(2max) less than 10 mL/kg/min (or <35% of predicted) indicates a high risk for major lung resection.
Authors:
Alessandro Brunelli
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery     Volume:  22     ISSN:  1532-9488     ISO Abbreviation:  Semin. Thorac. Cardiovasc. Surg.     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917640     Medline TA:  Semin Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2-13     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Division of Thoracic Surgery, Ospedali Riuniti, Ancona, Italy.
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