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Submaximal Invasive Exercise Testing and Quantitative Lung Scanning in the Evaluation for Tolerance of Lung Resection
Section snippets
Patients
Between July 1981 and June 1987, those patients demonstrating roentgenographically, a lung mass or infiltrate either diagnosed or suspected as malignant, were referred for routine pulmonary function testing. If, after appropriate therapy, their postbronchodilator FEV1 was$lj2.0 L or MVV <50 percent predicted, they were accepted for the study. Following an extensive explanation, they then gave written consent to participate in the study. The study itself and the form used for consent were
RESULTS
A group of 52 male patients qualified for the protocol. The data on the entire group reveal the mean age to be 64 ± 5 years, FEV1 = 1.56 ± 0.29 L, MVV = 61 ± 16 percent of predicted and DL/VA = 3.61 ±1.46 (normal = 6.93 - .033 age). Twenty-nine patients underwent an operation and their data are available for analysis. The remaining 23 patients are excluded for the reasons listed in Table 1. In seven of the excluded patients, anatomic unresectability became apparent either during, or shortly
DISCUSSION
In this study of patients with a lung mass and abnormal spirometry, submaximal exercise testing revealed differences between those tolerating and those intolerant of lung resection. Using preoperative physiologic criteria of PVR and predicted postoperative FEV1, we only rejected two patients as inoperable. However, seven patients failed to tolerate the resection. The major factors which characterized this intolerance appeared to be death following postoperative pneumonia and ventilator
ACKNOWLEDGMENT
We thank all previous pulmonary fellows who assisted with these studies; Mildred Corbett, Celeste Reynolds, and Melissa Fisher for their technical assistance; and Mrs Hume Fulmer for her secretarial skill.
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Manuscript received March 31; revision accepted June 13.