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Eur J Cardiothorac Surg 2003;24:145-148
© 2003 Elsevier Science NL

Predictors of exercise oxygen desaturation following major lung resection

Unit of Thoracic Surgery, Department of Respiratory Diseases, ‘Umberto I’ Hospital, Ancona, Italy

Received 12 December 2002; received in revised form 8 March 2003; accepted 17 March 2003.

^* Corresponding author. Via S. Margherita 23, 60129 Ancona, Italy. Tel.: +39-071-59-644-39; fax: +39-071-596-4433
e-mail: alexit_2000{at}yahoo.com

Objective: To identify predictors of postoperative exercise oxygen desaturation (EOD) in patients submitted to lobectomy or pneumonectomy for lung carcinoma. Patients and methods: A consecutive series of 227 patients with non-small cell lung cancer submitted to lobectomy or pneumonectomy from January 2000 through October 2002 were prospectively analyzed. Maximal stair-climbing tests were performed preoperatively (the day before the operation) and postoperatively (on average, 9.2 days after operation) in room air for all patients. A fall in oxygen saturation during the exercise below 90% was termed ‘desaturation’. Univariate and multivariate analyses were performed to identify predictors of postoperative EOD. Results: Thirty-five patients (15.4%) developed postoperative EOD. After multivariate analysis, the only independent predictor of postoperative EOD resulted a reduction in oxygen saturation during the preoperative exercise (P=0.0004). Conclusions: Patients with a reduction in oxygen saturation during the preoperative exercise test are at increased risk to develop a postoperative EOD below 90%. A postoperative exercise test should be performed in all these patients. Should EOD be confirmed, an intermittent home oxygen therapy is recommended in order to facilitate recovery from operation and improve the quality of life.

Key Words: Exercise test • Stair-climbing test • Oxygen desaturation • Lung resection • Lung cancer

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