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1 West Park Healthcare Centre, and2 the Lung Volume Reduction Surgery Clinic, University Health Network, University of Toronto, Toronto, 3 Hopital Laval, Sainte-Foy, Quebec, and 4 McMaster University Health Sciences Centre, Hamilton, Canada
CORRESPONDENCE: R.S. Goldstein, West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, Ontario, M6M 2J5, Canada. Fax: 1 4162438947. E-mail: rgoldstein@westpark.org
Keywords: chronic obstructive pulmonary disease, exercise, lung volume reduction surgery, prospective study, pulmonary gas exchange, randomised controlled trial
Received: June 17, 2003
Accepted October 19, 2003
This study was supported, in part, by the Physician's Services Incorporated Foundation (Ontario, Canada) and by West Park Healthcare Centre Foundation.
Although the influence of lung volume reduction surgery (LVRS) on incremental- and constant-power exercise is important in the evaluation of this procedure for patients with chronic obstructive pulmonary disease (COPD), it is rarely reported even in large randomised controlled trials.
This report describes 39 patients with severe COPD ((mean±se) forced expiratory volume in one second 32±2% pred, functional residual capacity 195±6% pred) who participated in a randomised controlled trial of LVRS and who completed incremental exercise tests at 6 months as well as endurance tests (constant power of 25±1 W) at 3, 9 and 12 months.
Peak oxygen uptake (V'o2,pk) was similar between the treatment (n=19) and control groups (n=20) at baseline. After LVRS, the treatment group had a significantly greater V'o2,pk (mean difference (95% CI) 1.28 (0.07–2.50) mL·kg·min–1) and power (13 (6–20) W). The treatment group achieved a significantly greater minute ventilation (7.1 (2.9–11.3) L·min–1) with a greater tidal volume (0.16 (0.04–0.28) L). Baseline endurance was similar between groups. After surgery, there were significant between-group differences in endurance time, which were maintained at 12 months (7.3 (3.9–10.8) min).
Lung volume reduction surgery is associated with an increase in exercise capacity and endurance, as compared with conventional medical treatment.
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