Preoperative maximal exercise oxygen consumption test predicts postoperative pulmonary morbidity following major lung resection

Abstract

Background and objective: Pulmonary resection carries a significant morbidity and mortality. The utility of maximal oxygen uptake test (VO 2max) to predict cardiopulmonary complications following major pulmonary resection was evaluated. Methods: Following standard preoperative work-up and VO2max testing, 55 patients (49 male; mean age 59 years, range 20-74) underwent major pulmonary surgery: lobectomy (n = 31), bilobectomy (n = 6) and pneumonectomy (n = 18). An investigator blinded to the preoperative assessment prospectively collected data on postoperative cardiopulmonary complications. Patients were divided into two groups according to preoperative VO2max and also according to FEV1. The frequency of postoperative complications in the groups was compared. Results: Complications were observed in 19 (34.5%) patients, 11 of which were pulmonary (20%). There were two deaths (3.6%), both due to respiratory failure. Preoperative FEV 1 failed to predict postoperative respiratory complications. Five of 36 patients with a preoperative FEV1 > 2 L suffered pulmonary complications, compared with six of 19 patients with FEV1 < 2 L. Cardiopulmonary complications were not observed in patients with VO 2max > 15 mL/kg/min (n = 27); however, 11 patients with VO 2max < 15 mL/kg/min (n = 28) suffered cardiopulmonary complications (P < 0.05). Conclusion: VO2max predicts postoperative pulmonary complications following major lung resection, and the risk of complications increases significantly when the preoperative VO 2max is less than 15 mL/kg/min. © 2007 The Authors.