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Ann Thorac Surg 2003;76:376-380
© 2003 The Society of Thoracic Surgeons

Original article: general thoracic

Predicted versus observed maximum oxygen consumption early after lung resection

Alessandro Brunelli, MDa*, Marco Monteverde, MDa, Alessandro Borri, MDa, Michele Salati, MDa, Majed Al Refai, MDa, Aroldo Fianchini, MDa

a Department of Thoracic Surgery, "Umberto I°" Regional Hospital, Ancona, Italy

Accepted for publication February 14, 2003.

* Address reprint requests to Dr Brunelli, Via S Margherita 23, Ancona 60129, Italy
e-mail: alexit_2000{at}yahoo.com

BACKGROUND: The objective of this study was to identify the predictors of underestimation and overestimation of postoperative maximum oxygen consumption (O2max).

METHODS: A prospective analysis was performed on 229 patients who had 38 pneumonectomies, 171 lobectomies, and 20 segmentectomies. All patients performed a preoperative and postoperative (on average 9.2 days after surgery) maximal stair-climbing test. Predicted postoperative O2max (ppoO2max) was calculated on the basis of the number of functioning segments removed during operation. The patients were divided into three groups: group A (158 cases), patients with a ppoO2max within 1 standard deviation of the observed postoperative O2max; group B (56 cases), patients with a difference between the observed postoperative O2max and ppoO2max greater than 1 standard deviation (underestimation); and group C (15 cases), patients with a difference between ppoO2max and the observed postoperative O2max greater than 1 standard deviation (overestimation). Univariate and multivariate analyses were performed.

RESULTS: The only significant predictor of underestimation was a high percentage of functional parenchyma removed during operation (p < 0.0001). The significant predictors of overestimation were a low percentage of functional parenchyma removed during operation (p = 0.01) and a high preoperative O2max (p = 0.002).

CONCLUSIONS: The prediction of postoperative O2max was not accurate in all patients. Those with a large amount of functional lung tissue removed during operation tended to have a postoperative O2max greater than expected. Conversely, those patients with a small amount of functional lung tissue resected tended to have a postoperative O2max lower than predicted.




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A. Brunelli, F. Xiume, M. Refai, M. Salati, R. Marasco, V. Sciarra, and A. Sabbatini
Evaluation of Expiratory Volume, Diffusion Capacity, and Exercise Tolerance Following Major Lung Resection: A Prospective Follow-up Analysis
Chest, January 1, 2007; 131(1): 141 - 147.
[Abstract] [Full Text] [PDF]


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