Cardiopulmonary exercise testing for risk prediction in major abdominal surgery

Denny Z H Levett; Michael P W Grocott

doi:10.1016/j.anclin.2014.11.001

Cardiopulmonary exercise testing for risk prediction in major abdominal surgery

Anesthesiol Clin. 2015 Mar;33(1):1-16. doi: 10.1016/j.anclin.2014.11.001.

Authors

Denny Z H Levett¹, Michael P W Grocott²

Affiliations

¹ Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK; Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6DY, UK; Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6DY, UK.
² Integrative Physiology and Critical Illness Group, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK; Critical Care Research Area, Southampton NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6DY, UK; Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton SO16 6DY, UK. Electronic address: mike.grocott@soton.ac.uk.

PMID: 25701925
DOI: 10.1016/j.anclin.2014.11.001

Abstract

Reduced exercise capacity is associated with increased postoperative morbidity. Cardiopulmonary exercise testing variables can be used to risk stratify patients. This information can be used to help guide the choice of surgical procedure and to decide on the most appropriate postoperative care environment. Thus CPET can aid collaborative decision making and improve the process of informed consent. In the future, CPET may be combined with other risk predictors to improve outcome prediction. Furthermore early evidence suggests that CPET can be used to guide prehabilitation training programs, improving fitness and thereby reducing perioperative risk.

Keywords: Anaerobic threshold (AT); Cardiopulmonary exercise testing; Collaborative decision making; Functional capacity; Incremental exercise test; Peak oxygen consumption (o(2) peak); Preoperative; Risk assessment.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Abdomen / surgery*
Exercise Test / methods*
Humans
Oxygen Consumption
Postoperative Complications / diagnosis*
Predictive Value of Tests
Preoperative Care / methods*
Risk Assessment