PT  - JOURNAL ARTICLE
AU  - M. Licker
AU  - J-M. Schnyder
AU  - J-G. Frey
AU  - J. Diaper
AU  - V. Cartier
AU  - C. Inan
AU  - J. Robert
AU  - P-O. Bridevaux
AU  - J-M. Tschopp
TI  - Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery
AID  - 10.1183/09031936.00069910
DP  - 2011 May 01
TA  - European Respiratory Journal
PG  - 1189--1198
VI  - 37
IP  - 5
4099  - http://erj.ersjournals.com/content/37/5/1189.short
4100  - http://erj.ersjournals.com/content/37/5/1189.full
SO  - Eur Respir J2011 May 01; 37
AB  - Over the past decades, major progress in patient selection, surgical techniques and anaesthetic management have largely contributed to improved outcome in lung cancer surgery. The purpose of this study was to identify predictors of post-operative cardiopulmonary morbidity in patients with a forced expiratory volume in 1 s <80% predicted, who underwent cardiopulmonary exercise testing (CPET). In this observational study, 210 consecutive patients with lung cancer underwent CPET with completed data over a 9-yr period (2001–2009). Cardiopulmonary complications occurred in 46 (22%) patients, including four (1.9%) deaths. On logistic regression analysis, peak oxygen uptake (peak V′O2) and anaesthesia duration were independent risk factors of both cardiovascular and pulmonary complications; age and the extent of lung resection were additional predictors of cardiovascular complications, whereas tidal volume during one-lung ventilation was a predictor of pulmonary complications. Compared with patients with peak V′O2 >17 mL·kg−1·min−1, those with a peak V′O2 <10 mL·kg−1·min−1 had a four-fold higher incidence of cardiac and pulmonary morbidity. Our data support the use of pre-operative CPET and the application of an intra-operative protective ventilation strategy. Further studies should evaluate whether pre-operative physical training can improve post-operative outcome.