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Cardiopulmonary exercise testing and surgery

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https://www.readbyqxmd.com/read/29766735/-a-case-of-post-intubation-tracheal-stenosis-mimicking-bronchial-asthma-case-report
#1
Monika Šatánková, Kristián Brat, Zdeněk Merta, Miloš Šteffl
Postintubation tracheal stenosis (PITS) is one of the most frequent causes of lower airways obstruction. Usually, PITS is the consequence of prolonged intubation period, but may occur also after short-term intubation. Diagnosis may be difficult if stridor is not present and the post-extubation period is many years long. Bronchoscopy and CT scanning are the diagnostic gold standard. In some cases, lung function tests may also be helpful. Treatment options include conservative treatment, surgery and endoscopic methods...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29722491/-routine-preoperative-testing-in-adults-undergoing-elective-non-cardiothoracic-surgery
#2
REVIEW
N Benahmed, G Briat, K Rondia, J Vlayen
INTRODUCTION: The Belgian Health Care Knowledge Center (KCE) developed a guideline about routine preoperative testing in adults undergoing elective non-cardiothoracic surgery. The guideline is intended for all care providers involved in the preoperative and perioperative management (incl. anesthesiologists, surgeons, cardiologists, lung specialists, radiologists, clinical biologists, general practitioners, etc). METHOD: A recent English guideline published by NICE (National Institute for Health and Care Excellence) was used as a starting point and adapted to the Belgian context...
2018: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/29708035/gender-differences-in-outcomes-after-aortic-aneurysm-surgery-should-foster-further-research-to-improve-screening-and-prevention-programmes
#3
Francesco Nicolini, Antonella Vezzani, Francesco Corradi, Riccardo Gherli, Filippo Benassi, Tullio Manca, Tiziano Gherli
Background Gender-related biases in outcomes after thoracic aortic surgery are an important factor to consider in the prevention of potential complications related to aortic diseases and in the analysis of surgical results. Methods The aim of this study is to provide an up-to-date review of gender-related differences in the epidemiology, specific risk factors, outcome, and screening and prevention programmes in aortic aneurysms. Results Female patients affected by aortic disease still have worse outcomes and higher early and late mortality than men...
June 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29692190/routine-pre-and-post-neoadjuvant-chemotherapy-fitness-testing-is-not-indicated-for-oesophagogastric-cancer-surgery
#4
R J Drummond, D Vass, H Wadhawan, C F Craig, C K MacKay, G M Fullarton, M J Forshaw
Introduction There is a known correlation between anaerobic threshold (AT) during cardiopulmonary exercise testing and development of cardiopulmonary complications in high-risk patients undergoing oesophagogastric cancer surgery. This study aimed to assess the value of routine retesting following neoadjuvant chemotherapy. Methods Patients undergoing neoadjuvant chemotherapy with subsequent oesophagogastric cancer surgery with pre- and post-neoadjuvant chemotherapy cardiopulmonary exercise data were identified from a prospectively maintained database...
April 25, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29601082/cardiopulmonary-fitness-before-and-after-neoadjuvant-chemotherapy-in-patients-with-oesophagogastric-cancer
#5
M Navidi, A W Phillips, S M Griffin, K E Duffield, A Greystoke, K Sumpter, R C F Sinclair
BACKGROUND: Neoadjuvant chemotherapy may have a detrimental impact on cardiorespiratory reserve. Determination of oxygen uptake at the anaerobic threshold by cardiopulmonary exercise testing (CPET) provides an objective measure of cardiorespiratory reserve. Anaerobic threshold can be used to predict perioperative risk. A low anaerobic threshold is associated with increased morbidity after oesophagogastrectomy. The aim of this study was to establish whether neoadjuvant chemotherapy has an adverse effect on fitness, and whether there is recovery of fitness before surgery for oesophageal and gastric adenocarcinoma...
March 30, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29581673/changes-in-exercise-tolerance-and-quality-of-life-are-unrelated-in-lung-cancer-survivors-who-undergo-video-assisted-thoracic-surgery
#6
Kunihiko Anami, Jun Horie, Yoshiyasu Hirayama, Naoki Yamashita, Kenichi Ito
[Purpose] The associations between changes in respiratory function, exercise tolerance, and quality of life (QOL) in patients with lung cancer who undergo lobectomy using video-assisted thoracoscopic surgery (VATS) are unclear. This study aimed to investigate the relationships between exercise tolerance and QOL in patients who underwent VATS. [Subjects and Methods] Thirty-six patients with lung cancer were followed for 3 months after VATS. Patients were evaluated before and 1, 4, and 12 weeks after surgery...
March 2018: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/29555526/neoadjuvant-therapy-reduces-cardiopulmunary-function-in-patients-undegoing-oesophagectomy
#7
Iain G Thomson, Matthew P Wallen, Adrian Hall, Rebekah Ferris, David C Gotley, Andrew P Barbour, Andrew Lee, Janine Thomas, Bernard M Smithers
Neoadjuvant therapy (NAT) for oesophageal cancer may reduce cardiopulmonary function, assessed by cardiopulmonary exercise testing (CPEX). Impaired cardiopulmonary function is associated with mortality following esophagectomy. We sought to assess the impact of NAT on cardiopulmonary function using CPEX and assessing the clinical relevance of any change in particular if changes were associated with post-operative morbidity. This was a prospective, cohort study of 40 patients in whom CPEX was performed before and after NAT...
May 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29508686/right-ventricular-pressure-response-to-exercise-in-adults-with-isolated-ventricular-septal-defect-closed-in-early-childhood
#8
Thomas Moller, Harald Lindberg, May Brit Lund, Henrik Holmstrom, Gaute Dohlen, Erik Thaulow
We previously demonstrated an abnormally high right ventricular systolic pressure response to exercise in 50% of adolescents operated on for isolated ventricular septal defect. The present study investigated the prevalence of abnormal right ventricular systolic pressure response in 20 adult (age 30-45 years) patients who underwent surgery for early ventricular septal defect closure and its association with impaired ventricular function, pulmonary function, or exercise capacity. The patients underwent cardiopulmonary tests, including exercise stress echocardiography...
March 6, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29474884/cardiopulmonary-exercise-testing-in-hepato-biliary-pancreas-cancer-surgery-a-systematic-review-are-we-any-further-than-walking-up-a-flight-of-stairs
#9
REVIEW
R Kumar, G Garcea
INTRODUCTION: Cardiopulmonary exercise testing (CPET) is a reliable, reproducible and non-invasive measure of functional capacity. CPET has been increasingly used to assess pre-operative risk and stratify patients at risk of mortality and morbidity following surgery. CPET parameters that predict outcomes within liver and pancreas cancer surgery still remain to be defined. METHODS: A systematic review to assess CPET use in predicting post-operative outcomes in liver and pancreas cancer surgery was carried out using the following databases AMED, CINAHL, Cochrane Library, EMBASE, Google Scholar and PubMED...
April 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29473337/acoustic-radiation-force-impulse-of-the-liver-after-fontan-operation-correlation-with-cardiopulmonary-exercise-test
#10
Michael V Di Maria, Lindsey Silverman, Adel K Younoszai, Mariana L Meyers, Kelley E Capocelli, Michael R Narkewicz
BACKGROUND: The current management paradigm for children with single ventricle heart disease involves a series of palliative surgeries, culminating in the Fontan operation. This physiology results in a high central venous pressure, and in the setting of single ventricle heart disease, results in hepatic injury and fibrosis over time. Fontan-associated liver disease (FALD) is universally present in this cohort, and the current gold standard for diagnosis remains biopsy. Noninvasive assessments of liver fibrosis, such as ultrasound with elastography or acoustic radiation force impulse (ARFI), has been utilized in this cohort...
February 23, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29466168/-lung-ventilation-efficiency-and-quality-of-life-after-orthotopic-heart-transplantation
#11
O V Kamenskaya, I Y Loginova, D V Doronin, A M CHernyavskiy
Aim of the study was assessment of efficiency of lung ventilation and its relationship with quality of life in patients undergoing orthotopic heart transplantation (OHT). MATERIALS AND METHODS: The study involved 40 patients with terminal chronic heart failure (CHF) included in the waiting list for heart transplantation. Before surgery and after OHT all patients underwent cardiopulmonary exercise testing, evaluation of clinical status and quality of life (QL) according to the 36-Item Short Form Survey (SF-36)...
January 2018: Kardiologiia
https://www.readbyqxmd.com/read/29456045/hepatectomy-for-octogenarians-with-colorectal-liver-metastasis-in-the-era-of-enhanced-recovery
#12
Andrea Tufo, Declan F J Dunne, Nichola Manu, Heman Joshi, Carmen Lacasia, Louise Jones, Hassan Z Malik, Graeme J Poston, Stephen W Fenwick
BACKGROUND: Concern exists regarding the use of hepatectomy to treat colorectal liver metastasis (CRLM) in octogenarians due to prior studies suggesting elevated morbidity and mortality. Cardiopulmonary exercise testing (CPET) within pre-operative assessment and enhanced recovery after surgery (ERAS) have both been shown to be associated with low morbidity and mortality in patients undergoing hepatectomy. This study sought to compare the outcomes of octogenarians with patients aged 70-79 undergoing hepatectomy for CRLM, within a center utilizing both CPET and ERAS...
February 6, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29455794/effect-of-ventricular-function-and-volumes-on-exercise-capacity-in-adults-with-repaired-tetralogy-of-fallot
#13
Natalia Dłużniewska, Piotr Podolec, Tomasz Miszalski-Jamka, Maciej Krupiński, Paweł Banyś, Małgorzata Urbańczyk, Bogdan Suder, Grzegorz Kopeć, Maria Olszowska, Lidia Tomkiewicz-Pająk
OBJECTIVES: Investigate the effects of left and right ventricular function and severity of pulmonary valve regurgitation, quantified by cardiac magnetic resonance (CMR), on exercise tolerance in adult patients who underwent ToF repair at a young age. METHODS: This is a retrospective cohort study of 52 patients after ToF surgery and 33 age- and sex-matched healthy volunteers. CMR and cardiopulmonary exercise testing (CPET) were performed on all patients; CPET was performed on control subjects...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29452805/perioperative-cardiopulmonary-exercise-testing-cpet-consensus-clinical-guidelines-on-indications-organization-conduct-and-physiological-interpretation
#14
D Z H Levett, S Jack, M Swart, J Carlisle, J Wilson, C Snowden, M Riley, G Danjoux, S A Ward, P Older, M P W Grocott
The use of perioperative cardiopulmonary exercise testing (CPET) to evaluate the risk of adverse perioperative events and inform the perioperative management of patients undergoing surgery has increased over the last decade. CPET provides an objective assessment of exercise capacity preoperatively and identifies the causes of exercise limitation. This information may be used to assist clinicians and patients in decisions about the most appropriate surgical and non-surgical management during the perioperative period...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29452599/feasibility-and-acceptability-of-pre-operative-physical-activity-to-improve-patient-outcomes-after-major-cancer-surgery-study-protocol-for-a-pilot-randomised-controlled-trial-pepa-trial
#15
Daniel Steffens, Jane Young, Paula R Beckenkamp, James Ratcliffe, Freya Rubie, Nabila Ansari, Neil Pillinger, Michael Solomon
BACKGROUND: There is a need for evidence of the effectiveness of pre-operative exercise for patients undergoing major cancer surgery; however, recruitment to such trials can be challenging. The PrE-operative Physical Activity (PEPA) Trial will establish the feasibility and acceptability of a pre-operative exercise programme aimed to improve patient outcomes after cytoreductive surgery and pelvic exenteration. The secondary aim is to obtain pilot data on the likely difference in key outcomes (post-operative complications, length of hospital stay, post-operative functional capacity and quality of life) to inform the sample size calculation for the substantive randomised clinical trial...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29423173/cardiopulmonary-exercise-testing-cpet-in-the-united-kingdom-a-national-survey-of-the-structure-conduct-interpretation-and-funding
#16
T Reeves, S Bates, T Sharp, K Richardson, S Bali, J Plumb, H Anderson, J Prentis, M Swart, D Z H Levett
Background: Cardiopulmonary exercise testing (CPET) is an exercise stress test with concomitant expired gas analysis that provides an objective, non-invasive measure of functional capacity under stress. CPET-derived variables predict postoperative morbidity and mortality after major abdominal and thoracic surgery. Two previous surveys have reported increasing utilisation of CPET preoperatively in England. We aimed to evaluate current CPET practice in the UK, to identify who performs CPET, how it is performed, how the data generated are used and the funding models...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29397143/arterial-pulse-pressure-and-postoperative-morbidity-in-high-risk-surgical-patients
#17
G L Ackland, T E F Abbott, R M Pearse, S N Karmali, J Whittle, G Minto
BACKGROUND: Systemic arterial pulse pressure (systolic minus diastolic pressure) ≤53 mm Hg in patients with cardiac failure is correlated with reduced stroke volume and is independently associated with accelerated morbidity and mortality. Given that deconditioned surgical and heart failure patients share similar cardiopulmonary physiology, we examined whether lower pulse pressure is associated with excess morbidity after major surgery. METHODS: This was a prospective observational cohort study of patients deemed by their preoperative assessors to be at higher risk of postoperative morbidity...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29377872/systematic-review-and-meta-analysis-of-objective-assessment-of-physical-fitness-in-patients-undergoing-colorectal-cancer-surgery
#18
Chun Hin Angus Lee, Joseph C Kong, Hilmy Ismail, Bernhard Riedel, Alexander Heriot
BACKGROUND: Gas exchange-derived variables obtained from cardiopulmonary exercise testing allow objective assessment of functional capacity and hence physiological reserve to withstand the stressors of major surgery. Field walk tests provide an alternate means for objective assessment of functional capacity that may be cheaper and have greater acceptability, in particular, in elderly patients. OBJECTIVE: This systematic review evaluated the predictive value of cardiopulmonary exercise testing and field walk tests in surgical outcomes after colorectal surgery...
March 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29367222/left-ventricular-free-wall-rupture-that-occurred-during-a-cardiopulmonary-exercise-test
#19
Masaki Kodaira, Takahito Itoh, Kiyoshi Koizumi, Yohei Numasawa
Although exercise testing has become a standard procedure before discharge for patients with acute coronary syndrome, a fatal accident during the test is extremely rare. A 60-year-old man was admitted for a non-ST-segment elevation myocardial infarction. A coronary angiogram showed stenosis at the distal lesion of the circumflex, and a balloon angioplasty was performed. His recovery was smooth, and a cardiopulmonary exercise test was performed 5 days after admission. At 2.5 metabolic equivalents, he suddenly went into cardiac arrest, and percutaneous cardiopulmonary support was initiated...
January 24, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29349536/oxygen-uptake-efficiency-slope-and-prediction-of-post-operative-morbidity-and-mortality-in-patients-with-lung-cancer
#20
Sertaç Yakal, Sevtün Sofyalı, Berker Özkan, Safinaz Yıldız, Alper Toker, Erdem Kasikcioglu
OBJECTIVE: Peak oxygen consumption is a very valuable cardiopulmonary functional parameter in pre-operative evaluation of patients with lung cancer. However, it has several critical limitations for operability decision due to failure in achieving maximal level of exercise test for cases. The aim of this study was to reveal the importance of more accurate cardiopulmonary parameters that can be calculated from data of submaximal level test, such as oxygen uptake efficiency slope (OUES) and to determine whether it could be used in the operability decision phase for borderline cases by means of morbidity and mortality...
April 2018: Lung
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