Rest Ventilatory Parameters Predict Morbidity and Mortality in Thoracic Surgery

Study Overview
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Brief Summary
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Cardiopulmonary exercise testing is recommended for preoperative evaluation and risk stratification of lung resection candidates. Ventilatory efficiency (VE/VCO2 slope) has been shown to predict morbidity and mortality in lung resection candidates and has been shown superior to peak oxygen consumption (VO2). Patients with increased VE/VCO2 during exercise also exhibit increased VE/VCO2 ratio and decreased end-tidal CO2 at rest. Our first hypothesis is that rest ventilatory parameters predict morbidity and mortality in patients undergoing thoracic surgery. VE/VCO2 is well correlated with ventilation-perfusion mismatch, therefore it may be useful in hypoxemia prediction during one-lung ventilation during thoracic surgery. Our second hypothesis is that patients with high VE/VCO2 will be prone to hypoxemia development during one-lung ventilation.

Official Title
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Rest Ventilatory Parameters Predict Morbidity and Mortality in Patients Undergoing Thoracic Surgery

Conditions
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Pulmonary Complication, Cardiovascular Complication

Intervention / Treatment
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* Procedure: Thoracic surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: thoracotomy because of lung infiltration (confirmed or highly suspicious lung tumor) Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Thoracic surgery|Lung resection surgery|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pulmonary complications | Respiratory complications definition: pneumonia, atelectasis; respiratory failure needing mechanical ventilation; adult respiratory distress syndrome; pneumothorax present on the 3rd post-operative day; long-lasting pleural effusions present on the 3rd post-operative day | Respiratory complications will be assessed from the first 30 post-operative days or from the hospital stay. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intensive care length of stay | In all subjects, intensive care unit length of stay will be assessed. | From the first 30 post-operative days or from the hospital stay. | 
| Hospital length of stay | In all subjects, hospital length of stay will be assessed. | From the first 30 post-operative days or from the hospital stay. | 
| Cardiovascular complications | Cardiovascular complications definition: new arrhythmias (atrial fibrillation, supraventricular tachycardia, etc.); hypotension; heart failure; pulmonary edema; pulmonary embolism; myocardial infarction/minimal myocardial lesion; cardiopulmonary resuscitation | Cardiovascular complications will be assessed from the first 30 post-operative days or from the hospital stay. | 
| Mortality | In all subjects, 30 and 90 days mortality will be assessed. | 30 and 90 days after surgery. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cardiopulmonary exercise testing, thoracic surgery