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Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery

INTRODUCTION: An anaerobic threshold (AT) of <11ml/min/kg can identify patients at high risk of cardiopulmonary complications after major surgery. The aim of this study was to assess the value of cardiopulmonary exercise testing (CPET) in predicting cardiopulmonary complications in high risk pati...

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Autores principales: Moyes, LH, McCaffer, CJ, Carter, RC, Fullarton, GM, Mackay, CK, Forshaw, MJ
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Surgeons 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098578/
https://www.ncbi.nlm.nih.gov/pubmed/23484995
http://dx.doi.org/10.1308/003588413X13511609954897
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author Moyes, LH
McCaffer, CJ
Carter, RC
Fullarton, GM
Mackay, CK
Forshaw, MJ
author_facet Moyes, LH
McCaffer, CJ
Carter, RC
Fullarton, GM
Mackay, CK
Forshaw, MJ
author_sort Moyes, LH
collection PubMed
description INTRODUCTION: An anaerobic threshold (AT) of <11ml/min/kg can identify patients at high risk of cardiopulmonary complications after major surgery. The aim of this study was to assess the value of cardiopulmonary exercise testing (CPET) in predicting cardiopulmonary complications in high risk patients undergoing oesophagogastric cancer resection. METHODS: Between March 2008 and October 2010, 108 patients (83 men, 25 women) with a median age of 66 years (range: 38–84 years) underwent CPET before potentially curative resections for oesophagogastric cancers. Measured CPET variables included AT and maximum oxygen uptake at peak exercise (VO(2 )peak). Outcome measures were length of high dependency unit stay, length of hospital stay, unplanned intensive care unit (ICU) admission, and postoperative morbidity and mortality. RESULTS: The mean AT and VO(2) peak were 10.8ml/min/kg (standard deviation [SD]: 2.8ml/min/kg, range: 4.6–19.3ml/min/kg) and 15.2ml/min/kg (SD: 5.3ml/min/kg, range: 5.4–33.3ml/min/kg) respectively; 57 patients (55%) had an AT of <11ml/min/ kg and 26 (12%) had an AT of <9ml/min/kg. Postoperative complications occurred in 57 patients (29 cardiopulmonary [28%] and 28 non-cardiopulmonary [27%]). Four patients (4%) died in hospital and 21 (20%) required an unplanned ICU admission. Cardiopulmonary complications occurred in 42% of patients with an AT of <9ml/min/kg compared with 29% of patients with an AT of ≥9ml/min/kg but <11ml/min/kg and 20% of patients with an AT of ≥11ml/min/kg (p=0.04). There was a trend that those with an AT of <11ml/min/kg and a low VO(2) peak had a higher rate of unplanned ICU admission. CONCLUSIONS: This study has shown a correlation between AT and the development of cardiopulmonary complications although the discriminatory ability was low.
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spelling pubmed-40985782014-07-17 Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery Moyes, LH McCaffer, CJ Carter, RC Fullarton, GM Mackay, CK Forshaw, MJ Ann R Coll Surg Engl Upper GI INTRODUCTION: An anaerobic threshold (AT) of <11ml/min/kg can identify patients at high risk of cardiopulmonary complications after major surgery. The aim of this study was to assess the value of cardiopulmonary exercise testing (CPET) in predicting cardiopulmonary complications in high risk patients undergoing oesophagogastric cancer resection. METHODS: Between March 2008 and October 2010, 108 patients (83 men, 25 women) with a median age of 66 years (range: 38–84 years) underwent CPET before potentially curative resections for oesophagogastric cancers. Measured CPET variables included AT and maximum oxygen uptake at peak exercise (VO(2 )peak). Outcome measures were length of high dependency unit stay, length of hospital stay, unplanned intensive care unit (ICU) admission, and postoperative morbidity and mortality. RESULTS: The mean AT and VO(2) peak were 10.8ml/min/kg (standard deviation [SD]: 2.8ml/min/kg, range: 4.6–19.3ml/min/kg) and 15.2ml/min/kg (SD: 5.3ml/min/kg, range: 5.4–33.3ml/min/kg) respectively; 57 patients (55%) had an AT of <11ml/min/ kg and 26 (12%) had an AT of <9ml/min/kg. Postoperative complications occurred in 57 patients (29 cardiopulmonary [28%] and 28 non-cardiopulmonary [27%]). Four patients (4%) died in hospital and 21 (20%) required an unplanned ICU admission. Cardiopulmonary complications occurred in 42% of patients with an AT of <9ml/min/kg compared with 29% of patients with an AT of ≥9ml/min/kg but <11ml/min/kg and 20% of patients with an AT of ≥11ml/min/kg (p=0.04). There was a trend that those with an AT of <11ml/min/kg and a low VO(2) peak had a higher rate of unplanned ICU admission. CONCLUSIONS: This study has shown a correlation between AT and the development of cardiopulmonary complications although the discriminatory ability was low. Royal College of Surgeons 2013-03 2013-03 /pmc/articles/PMC4098578/ /pubmed/23484995 http://dx.doi.org/10.1308/003588413X13511609954897 Text en Copyright © 2013 Royal College of Surgeons http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Upper GI
Moyes, LH
McCaffer, CJ
Carter, RC
Fullarton, GM
Mackay, CK
Forshaw, MJ
Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery
title Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery
title_full Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery
title_fullStr Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery
title_full_unstemmed Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery
title_short Cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery
title_sort cardiopulmonary exercise testing as a predictor of complications in oesophagogastric cancer surgery
topic Upper GI
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098578/
https://www.ncbi.nlm.nih.gov/pubmed/23484995
http://dx.doi.org/10.1308/003588413X13511609954897
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