Review Note
Last Update: 03/02/2025 09:52 AM
Current Deck: ACG Part 2::Thoracic SSU
New Card (Unpublished)Currently Published Content
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Commit #292856
(Extra) Describe the broad principles of preoperative assessment for throacics
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Commit #292856Preoperative assessment
- History with focus on cardiopulmonary symptoms
- Underlying respiratory diagnosis (chronology, exacerbations, smoking history, functional capacity)
- Acute disease processes (eg. infection, bronchospasm, effusions)
- Treatment related side effects (eg. chemotherapy/radiotherapy)
- Other management (eg. chest drains, their status)
- Anaesthetic exam, cardiorespiratory examination
- Investigations: FBC (Hb, platelets, WCC), U+Es (Creat, K and Mg), G+H, recent CXR, PFTs (compulsory if lung reduction surgery), ABG +/- CT scan
Explain the 3-legged assessment of respiratory function pre lung resection
- Lung mechanics = getting oxygen -> measured via ppoFEV1%
- Lung Parenchyma = exchanging oxygen -> ppoDLCO%
- Cardiopulmonary reserve = delivering oxygen -> Vo2max
Shuttle walk test
- Two cones spaced 100m apart
- Walk between two cones at increasing pace until breathless
- >400m = VO2max >15mlO2/kg/min
- If unable to walk 400m → refer for CPET
Most useful value in CPET testing → VO2 peak