Evaluation of High-Risk Lung Resection Candidates: Pulmonary Haemodynamics versus Exercise Testing

Respiration ◽  
1994 ◽  
Vol 61 (4) ◽  
pp. 181-186 ◽  
Author(s):  
C.T. Bolliger ◽  
M. Solèr ◽  
P. Stulz’ ◽  
E. Grädel ◽  
J. Müller-Brand ◽  
...  
Keyword(s):  
High Risk ◽  
Exercise Testing ◽  
Lung Resection ◽  
Pulmonary Haemodynamics

scholarly journals Invasive exercise testing in the evaluation of patients at high-risk for lung resection

1998 ◽  
Vol 12 (6) ◽  
pp. 1429-1435 ◽  
Author(s):  
J. Ribas ◽  
O. Díaz ◽  
J.A. Barberà ◽  
M. Mateu ◽  
E. Canalís ◽  
...  
Keyword(s):  
High Risk ◽  
Exercise Testing ◽  
Lung Resection

Exercise Testing in the Evaluation of Patients at High Risk for Complications from Lung Resection

CHEST Journal ◽  
1992 ◽  
Vol 101 (2) ◽  
pp. 356-361 ◽  
Author(s):  
Rodolfo C. Morice ◽  
Edward J. peters ◽  
M. Bernadette Ryan ◽  
J.B. Putnam ◽  
M.K. Ali ◽  
...  
Keyword(s):  
High Risk ◽  
Exercise Testing ◽  
Lung Resection

Exercise Testing in Evaluating High-risk Patients for Resection

CHEST Journal ◽  
1994 ◽  
Vol 105 (5) ◽  
pp. 1617 ◽  
Author(s):  
James W. Adams ◽  
Patrick B. Hazard
Keyword(s):  
High Risk ◽  
Exercise Testing ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Can wearable technology be used to approximate cardiopulmonary exercise testing metrics?

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Laura Jones ◽  
Laura Tan ◽  
Suzanne Carey-Jones ◽  
Nathan Riddell ◽  
Richard Davies ◽  
...  
Keyword(s):  
Physical Activity ◽  
High Risk ◽  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Exercise Testing ◽  
Low Cost ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Wearable Device ◽  
Cardiopulmonary Exercise

Abstract Background Consumer wrist-worn wearable activity monitors are widely available, low cost and are able to provide a direct measurement of several markers of physical activity. Despite this, there is limited data on their use in perioperative risk prediction. We explored whether these wearables could accurately approximate metrics (anaerobic threshold, peak oxygen uptake and peak work) derived using formalised cardiopulmonary exercise testing (CPET) in patients undergoing high-risk surgery. Methods Patients scheduled for major elective intra-abdominal surgery and undergoing CPET were included. Physical activity levels were estimated through direct measures (step count, floors climbed and total distance travelled) obtained through continuous wear of a wrist worn activity monitor (Garmin Vivosmart HR+) for 7 days prior to surgery and self-report through completion of the short International Physical Activity Questionnaire (IPAQ). Correlations and receiver operating characteristic (ROC) curve analysis explored the relationships between parameters provided by CPET and physical activity. Device selection Our choice of consumer wearable device was made to maximise feasibility outcomes for this study. The Garmin Vivosmart HR+ had the longest battery life and best waterproof characteristics of the available low-cost devices. Results Of 55 patients invited to participate, 49 (mean age 65.3 ± 13.6 years; 32 males) were enrolled; 37 provided complete wearable data for analyses and 36 patients provided full IPAQ data. Floors climbed, total steps and total travelled as measured by the wearable device all showed moderate correlation with CPET parameters of peak oxygen uptake (peak VO2) (R = 0.57 (CI 0.29–0.76), R = 0.59 (CI 0.31–0.77) and R = 0.62 (CI 0.35–0.79) respectively), anaerobic threshold (R = 0.37 (CI 0.01–0.64), R = 0.39 (CI 0.04–0.66) and R = 0.42 (CI 0.07–0.68) respectively) and peak work (R = 0.56 (CI 0.27–0.75), R = 0.48 (CI 0.17–0.70) and R = 0.50 (CI 0.2–0.72) respectively). Receiver operator curve (ROC) analysis for direct and self-reported measures of 7-day physical activity could accurately approximate the ventilatory equivalent for carbon dioxide (VE/VCO2) and the anaerobic threshold. The area under these curves was 0.89 for VE/VCO2 and 0.91 for the anaerobic threshold. For peak VO2 and peak work, models fitted using just the wearable data were 0.93 for peak VO2 and 1.00 for peak work. Conclusions Data recorded by the wearable device was able to consistently approximate CPET results, both with and without the addition of patient reported activity measures via IPAQ scores. This highlights the potential utility of wearable devices in formal assessment of physical functioning and suggests they could play a larger role in pre-operative risk assessment. Ethics This study entitled “uSing wearable TEchnology to Predict perioperative high-riSk patient outcomes (STEPS)” gained favourable ethical opinion on 24 January 2017 from the Welsh Research Ethics Committee 3 reference number 17/WA/0006. It was registered on ClinicalTrials.gov with identifier NCT03328039.

scholarly journals Complex pulmonary aspergilloma treated by cavernostomy

2014 ◽  
Vol 41 (6) ◽  
pp. 406-411 ◽  
Author(s):  
Paula dos Santos Marsico Pereira da Silva ◽  
Giovanni Antonio Marsico ◽  
Marcell Alex Ferraz Araujo ◽  
Fernando Soares Vannucci Braz ◽  
Heron Teixeira Andrade dos Santos ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Records ◽  
Operative Time ◽  
Lung Resection ◽  
Signs And Symptoms ◽  
Etiologic Agent ◽  
Treatment Alternative ◽  
Pulmonary Aspergilloma ◽  
The Mean ◽  
Pulmonary Bleeding

Objective: To evaluate the effectiveness of cavernostomy in patients with complex fungal balls.Methods: We analyzed the medical records of patients undergoing cavernostomy between January 2005 and May 2013, evaluating: age, gender, preoperative signs and symptoms, predisposing disease, preoperative tests, location of the aspergilloma, etiologic agent, cavernostomy indication, postoperative outcome.Results: Ten patients were male. The mean age was 42.9 years (34-56). The most frequent symptom was repeated pulmonary bleeding. Cavernostomy was proposed for patients at high risk for lung resection. It was performed in 17 patients and all of them had pulmonary tuberculosis sequelae, with cavitations. The indication in all cases was hemoptysis and elimination of phlegm. The cavernostomies were performed in a single surgical procedure. In all 17 patients the cavity was left open after the withdrawal of the mycetoma. In all patients hemoptysis ceased immediately. Operative mortality was 9.5% (1).Conclusion: cavernostomy is an effective treatment alternative in patients at high risk. It may be useful in some patients with complex aspergilloma, irrespective of lung function or bilateral disease. It is technically easy, has low-risk, saves parenchyma, and may be performed in a single operative time.

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

2013 ◽  
Vol 95 (2) ◽  
pp. 125-130 ◽  
Author(s):  
LH Moyes ◽  
CJ McCaffer ◽  
RC Carter ◽  
GM Fullarton ◽  
CK Mackay ◽  
...  
Keyword(s):  
High Risk ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Major Surgery ◽  
Peak Exercise ◽  
Icu Admission ◽  
Cardiopulmonary Exercise ◽  
High Dependency ◽  
Cardiopulmonary Complications ◽  
Oesophagogastric Cancer

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 (VO2 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 VO2 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 VO2 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.

scholarly journals A non-exercise method to determine cardiorespiratory fitness identifies females predicted to be at ‘high risk’ of type 2 diabetes

2016 ◽  
Vol 14 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Benjamin J Gray ◽  
Jeffrey W Stephens ◽  
Daniel Turner ◽  
Michael Thomas ◽  
Sally P Williams ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
High Risk ◽  
Risk Score ◽  
Exercise Testing ◽  
Diabetes Risk ◽  
Testing Method ◽  
Metabolic Equivalents

This study examined the relationship between cardiorespiratory fitness determined by a non-exercise testing method for estimating fitness and predicted risk of developing type 2 diabetes mellitus using five risk assessments/questionnaires (Leicester Diabetes Risk Score, QDiabetes, Cambridge Risk Score, Finnish Diabetes Risk Score and American Diabetes Association Diabetes Risk Test). Retrospective analysis was performed on 330 female individuals with no prior diagnosis of cardiovascular disease or type 2 diabetes mellitus who participated in the Prosiect Sir Gâr workplace initiative in Carmarthenshire, South Wales. Non-exercise testing method for estimating fitness (expressed as metabolic equivalents) was calculated using a validated algorithm, and females were grouped accordingly into fitness quintiles <6.8 metabolic equivalents (Quintile 1), 6.8–7.6 metabolic equivalents (Quintile 2), 7.6–8.6 metabolic equivalents (Quintile 3), 8.6–9.5 metabolic equivalents (Quintile 4), >9.5 metabolic equivalents (Quintile 5). Body mass index, waist circumference, and HbA1c all decreased between increasing non-exercise testing method for estimating fitness quintiles ( p < 0.05), as did risk prediction scores in each of the five assessments/questionnaires ( p < 0.05). The proportion of females in Quintile 1 predicted at ‘high risk’ was between 20.9% and 81.4%, depending on diabetes risk assessment used, compared to none of the females in Quintile 5. A calculated non-exercise testing method for estimating fitness <6.8 metabolic equivalents could help to identify females at ‘high risk’ of developing type 2 diabetes mellitus as predicted using five risk assessments/questionnaires.

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