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Cardiopulmonary exercise testing and surgery

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https://www.readbyqxmd.com/read/27916346/cardiopulmonary-exercise-testing-is-a-better-outcome-predictor-than-exercise-echocardiography-in-asymptomatic-aortic-stenosis
#1
Olivia Domanski, Marjorie Richardson, Augustin Coisne, Anne-Sophie Polge, Stephanie Mouton, François Godart, Jean Louis Edmé, Regis Matran, Patrizio Lancellotti, David Montaigne
BACKGROUND: Objective assessment of maximal aerobic capacity using peak oxygen consumption (peak VO2) can be helpful in the management of patients with asymptomatic aortic stenosis (AS). The relationship between peak VO2 and AS severity criteria derived from rest and supine exercise echocardiography (SEE) has never been explored. OBJECTIVES: We aimed to determine whether low peak VO2 (<85% of predicted value) is associated with severity parameters in SEE, and poor clinical outcome...
November 3, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27875636/evaluation-of-coronary-artery-disease-in-potential-liver-transplant-recipients
#2
REVIEW
Brian J Hogan, Enoka Gonsalkorala, Michael A Heneghan
Improvements in the management of patients undergoing Liver Transplantation (LT) have resulted in a significant increase in survival over recent years. Cardiac disease is now the leading cause of early mortality and the stress of major surgery, haemodynamic shifts, the possibility of haemorrhage or reperfusion syndrome require the recipient to have good baseline cardiac function. The prevalence of coronary artery disease (CAD) is increasing in liver transplant candidates, especially in those with Non-Alcohol related Fatty Liver Disease (NAFLD)...
November 22, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27872897/physiotherapy-practice-patterns-for-management-of-patients-undergoing-thoracic-surgeries-in-india-a-survey
#3
Sagarika Sultanpuram, Gopala Krishna Alaparthi, Shyam Krishnan Krishnakumar, Zulfeequer C P Ottayil
Aim. The aim of the current study is to determine the practice patterns of physiotherapists for patients undergoing thoracic surgeries in India. Materials and Methodology. A cross-sectional survey was conducted across India in which 600 questionnaires were sent in emails to physiotherapists. The questionnaire addressed assessment and treatment techniques of thoracic surgery. Results. A total of 234 completed questionnaires were returned with a response rate of 39%, with the majority of responses received from Telangana, Karnataka, and Andhra Pradesh...
2016: Surgery Research and Practice
https://www.readbyqxmd.com/read/27865641/canadian-cardiovascular-society-guidelines-on-perioperative-cardiac-risk-assessment-and-management-for-patients-who-undergo-noncardiac-surgery
#4
Emmanuelle Duceppe, Joel Parlow, Paul MacDonald, Kristin Lyons, Michael McMullen, Sadeesh Srinathan, Michelle Graham, Vikas Tandon, Kim Styles, Amal Bessissow, Daniel I Sessler, Gregory Bryson, P J Devereaux
The Canadian Cardiovascular Society Guidelines Committee and key Canadian opinion leaders believed there was a need for up to date guidelines that used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system of evidence assessment for patients who undergo noncardiac surgery. Strong recommendations included: 1) measuring brain natriuretic peptide (BNP) or N-terminal fragment of proBNP (NT-proBNP) before surgery to enhance perioperative cardiac risk estimation in patients who are 65 years of age or older, are 45-64 years of age with significant cardiovascular disease, or have a Revised Cardiac Risk Index score ≥ 1; 2) against performing preoperative resting echocardiography, coronary computed tomography angiography, exercise or cardiopulmonary exercise testing, or pharmacological stress echocardiography or radionuclide imaging to enhance perioperative cardiac risk estimation; 3) against the initiation or continuation of acetylsalicylic acid for the prevention of perioperative cardiac events, except in patients with a recent coronary artery stent or who will undergo carotid endarterectomy; 4) against α2 agonist or β-blocker initiation within 24 hours before surgery; 5) withholding angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker starting 24 hours before surgery; 6) facilitating smoking cessation before surgery; 7) measuring daily troponin for 48 to 72 hours after surgery in patients with an elevated NT-proBNP/BNP measurement before surgery or if there is no NT-proBNP/BNP measurement before surgery, in those who have a Revised Cardiac Risk Index score ≥1, age 45-64 years with significant cardiovascular disease, or age 65 years or older; and 8) initiating of long-term acetylsalicylic acid and statin therapy in patients who suffer myocardial injury/infarction after surgery...
October 4, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27771425/short-term-preoperative-high-intensity-interval-training-in-patients-awaiting-lung-cancer-surgery-a-randomized-controlled-trial
#5
Marc Licker, Wolfram Karenovics, John Diaper, Isabelle Frésard, Frédéric Triponez, Christoph Ellenberger, Raoul Schorer, Bengt Kayser, Pierre-Olivier Bridevaux
BACKGROUND: Impairment in aerobic fitness is a potential modifiable risk factor for postoperative complications. In this randomized controlled trial, we hypothesized that a high-intensity interval training (HIIT) program enhances cardiorespiratory fitness before lung cancer surgery and therefore reduces the risk of postoperative complications. METHODS: Patients with operable lung cancer were randomly assigned to usual care (UC, N=77) or preoperative rehabilitation based on HIIT (Rehab, N=74)...
October 5, 2016: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/27730011/risk-stratification-in-lung-resection
#6
Michele Salati, Alessandro Brunelli
PURPOSE OF REVIEW: Surgery is considered the best treatment option for patients with early stage lung cancer. Nevertheless, lung resection may cause a variable functional impairment that could influence the whole cardio-respiratory system with potential life-threatening complications. The aim of the present study is to review the most relevant evidences about the evaluation of surgical risk before lung resection, in order to define a practical approach for the preoperative functional assessment in lung cancer patients...
2016: Current Surgery Reports
https://www.readbyqxmd.com/read/27711026/preoperative-functional-assessment-and-optimization-in-surgical-patient-changing-the-paradigm
#7
Francesco Carli, Enrico M Minnella
Functional capacity has been shown to be a major determinant of surgical outcome since it is related to postoperative complications, activity and daily function, level of independence and quality of life. Anesthesiologists as "perioperative physicians", can identify those scoring systems that assess functional capacity, whether from the basic physical history and walk test to the most complex such as cardiopulmonary exercise testing (CPET), and formulate intraoperative and postoperative interventions (rehabilitation) to minimize the impact of surgery on the recovery process...
October 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27687390/cardiopulmonary-exercise-testing-in-a-patient-with-a-permanent-tracheostomy
#8
Steven Tran, Anton Krige
The benefits of cardiopulmonary exercise testing have been well established. Certain patient groups present challenges for conducting such a test. We were presented with a patient with a permanent tracheostomy at the preoperative assessment clinic. We describe our technique in overcoming the problem of connecting him to the testing machine, as this is normally done with the aid of a tight-fitting face mask. We used a cuffed tracheostomy tube together with some widely available tubing from theaters to connect the patient to the gas analyzer...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27638412/cardiopulmonary-exercise-testing-has-no-additive-incremental-value-to-standard-scoring-systems-when-risk-stratifying-for-bariatric-surgery
#9
Samantha R Warnakulasuriya, David R Yates, Jonathan T Wilson, Michael Stone, Jonathan Redman, Simon Davies
BACKGROUND: Cardiopulmonary exercise testing (CPET) can identify patients at risk of adverse post-operative outcomes following major abdominal surgery including bariatric surgery. Scoring systems that also aim to predict post-operative outcome in this group include the validated obesity surgery mortality risk score (OSMRS). This study aims to investigate if CPET has additive value to other scoring systems in predicting post-operative outcomes following bariatric surgery. METHODS: Data was collected retrospectively on 398 patients who underwent CPET between October 2008 and April 2013...
September 16, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27589870/the-effect-of-neoadjuvant-chemotherapy-and-chemoradiotherapy-on-exercise-capacity-and-outcome-following-upper-gastrointestinal-cancer-surgery-an-observational-cohort-study
#10
M A West, L Loughney, G Ambler, B D Dimitrov, J J Kelly, M G Mythen, R Sturgess, P M A Calverley, A Kendrick, M P W Grocott, S Jack
BACKGROUND: In 2014 approximately 21,200 patients were diagnosed with oesophageal and gastric cancer in England and Wales, of whom 37 % underwent planned curative treatments. Potentially curative surgical resection is associated with significant morbidity and mortality. For operable locally advanced disease, neoadjuvant chemotherapy (NAC) improves survival over surgery alone. However, NAC carries the risk of toxicity and is associated with a decrease in physical fitness, which may in turn influence subsequent clinical outcome...
September 2, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27530099/cardiac-rehabilitation-in-very-old-adults-effect-of-baseline-functional-capacity-on-treatment-effectiveness
#11
Samuele Baldasseroni, Alessandra Pratesi, Sara Francini, Rachele Pallante, Riccardo Barucci, Francesco Orso, Costanza Burgisser, Niccolò Marchionni, Francesco Fattirolli
OBJECTIVES: To assess the effect of cardiac rehabilitation (CR) and identify predictors of changes in functional capacity with CR in a consecutive series of older adults with a recent cardiac event. DESIGN: Observational. SETTING: In-hospital CR unit. PARTICIPANTS: Individuals aged 75 and older referred to an outpatient CR Unit after an acute coronary event (unstable angina pectoris, acute myocardial infarction) or cardiac surgery (coronary artery bypass grafting, heart valve replacement or repair) (N = 160, mean age 80 ± 4)...
August 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27429732/exercise-therapy-in-primary-biliary-cirrhosis-the-importance-of-moving-while-sitting-on-a-surgical-waiting-list-a-case-study
#12
Kate Hallsworth, Laura Jopson, David E Jones, Michael I Trenell
BACKGROUND: It is being increasingly recognised that reduced cardiorespiratory fitness is associated with poorer outcomes after major surgery. Exercise limitation and reduced aerobic capacity are common in people with end-stage liver disease. There is limited evidence about the role of exercise therapy in the management of primary biliary cirrhosis (PBC) and no studies have looked at the effect of exercise in people with PBC who are awaiting liver transplantation. This case study is the first to report that personalised exercise therapy improves cardiorespiratory fitness in a patient with PBC without worsening symptoms of severe fatigue...
July 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/27324133/assessment-of-cardiopulmonary-responses-to-treadmill-walking-following-gastric-bypass-surgery
#13
Matthew G Browning, Robert L Franco, Jeffrey E Herrick, James A Arrowood, Ronald K Evans
BACKGROUND: Studies that have evaluated cardiopulmonary responses to exercise within the first few months of bariatric surgery have utilized cycle ergometry. However, walking is the most commonly reported mode of both pre- and post-operative PA. The divergent cardiopulmonary responses and metabolic costs of weight-bearing (walking) and non-weight-bearing (cycling) exercises warrant examination of the effects of bariatric surgery on cardiopulmonary responses during walking. METHODS: Nine women completed a maximal cardiopulmonary exercise test on a treadmill 2 weeks before and 3 months after gastric bypass surgery (GBS)...
June 20, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27232916/exercise-performance-in-ebstein-s-anomaly-in-the-course-of-time-deterioration-in-native-patients-and-preserved-function-after-tricuspid-valve-surgery
#14
Jan Müller, Andreas Kühn, Andrea Tropschuh, Alfred Hager, Peter Ewert, Christian Schreiber, Manfred Vogt
OBJECTIVE: The purpose of this study was to assess the longitudinal follow-up of exercise performance in patients with native Ebstein anomaly and patients who had received previous tricuspid valve surgery. PATIENTS AND METHODS: We identified 59 patients with Ebstein anomaly who had performed at least two cardiopulmonary exercise tests within a minimum of 6months. 22 patients (15 female, 29.0±13.4years) with native conditions, 37 patients (21 female, 32.1±15.3years) had undergone surgery of their tricuspid valve before baseline testing...
September 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27197920/benefits-of-robotic-cystectomy-with-intracorporeal-diversion-for-patients-with-low-cardiorespiratory-fitness-a-prospective-cohort-study
#15
Benjamin Wilfrid Lamb, Wei Shen Tan, Philip Eneje, David Bruce, Amy Jones, Imran Ahmad, Ashwin Sridhar, Hilary Baker, Tim P Briggs, John E Hines, Senthil Nathan, Daniel Martin, Robert C Stephens, John D Kelly
BACKGROUND: Patients undergoing radical cystectomy have associated comorbidities resulting in reduced cardiorespiratory fitness. Preoperative cardiopulmonary exercise testing (CPET) measures including anaerobic threshold (AT) can predict major adverse events (MAE) and hospital length of stay (LOS) for patients undergoing open and robotic cystectomy with extracorporeal diversion. Our objective was to determine the relationship between CPET measures and outcome in patients undergoing robotic radical cystectomy and intracorporeal diversion (intracorporeal robotic assisted radical cystectomy [iRARC])...
September 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27187100/fitness-during-breast-cancer-treatment-and-recovery-in-an-athlete-a-case-study
#16
Patrick D Savage, Kim Dittus, Susan G Lakoski
PURPOSE: This is a case study of an aerobically trained, multisport, female athlete (age = 39) diagnosed with stage IIIc human epidermal growth factor receptor 2 positive breast cancer. The focus of the study is on measures of cardiorespiratory fitness (V˙O2peak) through the course of cancer therapy. METHODS: A symptom-limited cardiopulmonary exercise tolerance test was performed to determine V˙O2peak. The tests were performed at five different time points: 1) at diagnosis of breast cancer and before initiating chemotherapy, 2) after completion of chemotherapy (5 months postdiagnosis), 3) 2...
October 2016: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/27175562/compromised-cardiopulmonary-exercise-capacity-in-patients-early-after-endoscopic-atraumatic-coronary-artery-bypass-graft-implications-for-rehabilitation
#17
Dominique Hansen, Ruben Roijakkers, Lore Jackmaert, Boris Robic, Marc Hendrikx, Alaaddin Yilmaz, Ines Frederix, Michael Rosseel, Paul Dendale
OBJECTIVE: The purpose of this work was to test the hypothesis that cardiopulmonary exercise tolerance is better preserved early after endoscopic atraumatic coronary artery bypass graft (endo-ACAB) surgery versus coronary artery bypass graft (CABG) surgery. DESIGN: Twenty endo-ACAB surgery patients, 20 CABG surgery patients, and 15 healthy subjects executed a maximal cardiopulmonary exercise test, with assessment and comparison of cycling power output, O2 uptake, CO2 output, respiratory gas exchange ratio, end-tidal O2 and CO2 pressures, equivalents for O2 uptake and CO2 output, heart rate, O2 pulse, expiratory volume, tidal volume, respiratory rate, at peak exercise and ventilatory threshold...
May 12, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27174411/surgical-risk-evaluation-of-lung-cancer-in-copd-patients-a-cohort-observational-study
#18
F Rodrigues, M Grafino, I Faria, J Pontes da Mata, A L Papoila, F Félix
Coexistence between pulmonary cancer and chronic obstructive pulmonary disease (COPD) is frequent and is anticipated to be lead to high worldwide mortality in the next decades. The most powerful therapeutic approach for non-small cell lung carcinoma is lung surgical resection. However, in COPD patients, this approach bears a higher mortality and morbidity risk, thus requiring an accurate pre-operatory evaluation of the surgical risk comprising a clinical and functional assessment at rest, as well as a cardiopulmonary exercise test...
September 2016: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/27165422/preoperative-peak-oxygen-uptake-in-lung-cancer-subjects-with-neoadjuvant-chemotherapy-a-cross-sectional-study
#19
Isabelle Fresard, Marc Licker, Dan Adler, Alban Lovis, John Robert, Wolfram Karenovics, John Diaper, Jean-Paul Janssens, Frederic Triponez, Frederic Lador, Thierry Rochat, Vicente Espinosa, Chetna Bhatia, Bengt Kayser, Pierre-Olivier Bridevaux
BACKGROUND: In non-small-cell lung cancer patients, high peak oxygen uptake (peak V̇O2 ) predicts lower rates of postoperative complications and better long-term survival. Neoadjuvant chemotherapy (NAC) may negatively impact peak V̇O2 . METHODS: Cardiopulmonary exercise testing (CPET) was performed in 34 consecutive stage IIIA/IIIB non-small-cell lung cancer subjects scheduled for elective lung surgery. Using multivariate linear regression adjusted for potential confounders, we compared CPET results in subjects receiving or not receiving NAC (NAC+, n = 19; NAC-, n = 15)...
August 2016: Respiratory Care
https://www.readbyqxmd.com/read/27156441/the-utility-of-exercise-testing-in-patients-with-lung-cancer
#20
REVIEW
Duc Ha, Peter J Mazzone, Andrew L Ries, Atul Malhotra, Mark Fuster
The harm associated with lung cancer treatment include perioperative morbidity and mortality and therapy-induced toxicities in various organs, including the heart and lungs. Optimal treatment therefore entails a need for risk assessment to weigh the probabilities of benefits versus harm. Exercise testing offers an opportunity to evaluate a patient's physical fitness/exercise capacity objectively. In lung cancer, it is most often used to risk-stratify patients undergoing evaluation for lung cancer resection...
September 2016: Journal of Thoracic Oncology
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