Lung Volume Reduction Surgery by Michael Argenziano, Mark E. Ginsburg

By Michael Argenziano, Mark E. Ginsburg

A panel of famous professionals comprehensively evaluate the clinical, surgical, and pathophysiologic concerns suitable to lung quantity aid surgical procedure for emphysema. subject matters variety from the open method and video-assisted thoracoscopic ways to LVRS, to anesthetic administration, to perioperative and nursing care of the sufferer. The specialists additionally element the choice of applicants for LVRS, the medical effects and scientific trials in LVRS, and the consequences of LVRS on survival premiums.

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46. Light RW, Mintz HM, Linden GS, Brown SE (1984) Hemodynamics of patients with severe chronic obstructive pulmonary disease during progressive upright exercise. Am Rev Respir Dis 130: 391–395. 47. Oswald-Mammosser M, Kessler R, Massard G, Wihlm J, Weitzenblum E, Lonsdorfer J (1998) Effect of lung volume reduction surgery on gas exchange and pulmonary hemodynamics at rest and during exercise. Am J Respir Crit Care Med 158: 1020–1025. 48. Wagner PD (1998) Functional consequences of lung volume reduction surgery for COPD (Editorial).

B. Saunders Co. 3. Goldring RM (1984) Specific defects in cardiopulmonary gas transport, Am Rev Respir Dis 129 (Suppl): S57–S59. 4. Blackie SP, Fairburn MS, McElvaney GN, Morrison NJ, Wilcox PG, Pardy RL (1989) Prediction of maximal oxygen uptake and power during cycle ergometry in subjects older than 55 years of age. Am Rev Respir Dis 139: 1424–1429. 5. Shephard RJ (1971) Standard tests of aerobic power, In: Shephard RJ, ed, Frontiers of Fitness. Springfield, IL: Charles C Thomas. 6. Shephard RJ (1966) The relative merits of the step test, bicycle and treadmill in the assessment of cardiorespiratory fitness.

Improvements in exercise tolerance following LVRS include longer 6-min walk distances, increased maximal workloads, higher maximal VO2, and improved indices of gas exchange (41). Currently in the NETT trial, the 6-min walk test, maximal VO2, and maximum work rate are measured, with the maximum work rate as one of two primary outcomes to be analyzed (13,23,42–45). Significant increases in the 6-min walk test have been noted following LVRS, from 300 to 370 m in normocapnic patients, and from 197 to 274 m in hypercapnic patients.

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