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Peak oxygen uptake in combination with ventilatory efficiency improve risk stratification in major abdominal surgery
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US. Region Östergötland, Heart Center, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart Center, Department of Clinical Physiology in Linköping.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.ORCID iD: 0000-0001-9704-1260
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.ORCID iD: 0000-0002-8078-9528
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2024 (English)In: Physiological Reports, E-ISSN 2051-817X, Vol. 12, no 1, article id e15904Article in journal (Refereed) Published
Abstract [en]

This pilot study aimed to evaluate if peak VO2 and ventilatory efficiency in combination would improve preoperative risk stratification beyond only relying on peak VO2. This was a single-center retrospective cohort study including all patients who underwent cardiopulmonary exercise testing (CPET) as part of preoperative risk evaluation before major upper abdominal surgery during years 2008-2021. The primary outcome was any major cardiopulmonary complication during hospitalization. Forty-nine patients had a preoperative CPET before decision to pursue to surgery (cancer in esophagus [n = 18], stomach [6], pancreas [16], or liver [9]). Twenty-five were selected for operation. Patients who suffered any major cardiopulmonary complication had lower ventilatory efficiency (i.e., higher VE/VCO2 slope, 37.3 vs. 29.7, p = 0.031) compared to those without complications. In patients with a low aerobic capacity (i.e., peak VO2 < 20 mL/kg/min) and a VE/VCO2 slope >= 39, 80% developed a major cardiopulmonary complication. In this pilot study of patients with preoperative CPET before major upper abdominal surgery, patients who experienced a major cardiopulmonary complication had significantly lower ventilatory efficiency compared to those who did not. A low aerobic capacity in combination with low ventilatory efficiency was associated with a very high risk (80%) of having a major cardiopulmonary complication.

Place, publisher, year, edition, pages
WILEY , 2024. Vol. 12, no 1, article id e15904
Keywords [en]
abdominal surgery; cardiopulmonary exercise testing; exercise capacity; functional capacity; ventilatory efficiency
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-200246DOI: 10.14814/phy2.15904ISI: 001134587000001PubMedID: 38163673OAI: oai:DiVA.org:liu-200246DiVA, id: diva2:1829433
Note

Funding Agencies|ALF Grants

Available from: 2024-01-19 Created: 2024-01-19 Last updated: 2024-01-19

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Kristenson, KarolinaGerring, EdvardBjörnsson, BergthorSandström, PerHedman, Kristofer
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Division of Diagnostics and Specialist MedicineFaculty of Medicine and Health SciencesANOPIVA USDepartment of Thoracic and Vascular SurgeryDepartment of Clinical Physiology in LinköpingDivision of Surgery, Orthopedics and OncologyDepartment of Surgery in Linköping
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