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[A6 Cardiopulmonary exercise testing for collaborative decision making prior to major hepatobiliary surgery] Proceedings of the American Society for Enhanced Recovery/Evidence Based Peri-Operative Medicine 2016 Annual Congress of Enhanced Recovery and Perioperative Medicine

[A6 Cardiopulmonary exercise testing for collaborative decision making prior to major hepatobiliary surgery] Proceedings of the American Society for Enhanced Recovery/Evidence Based Peri-Operative Medicine 2016 Annual Congress of Enhanced Recovery and Perioperative Medicine
[A6 Cardiopulmonary exercise testing for collaborative decision making prior to major hepatobiliary surgery] Proceedings of the American Society for Enhanced Recovery/Evidence Based Peri-Operative Medicine 2016 Annual Congress of Enhanced Recovery and Perioperative Medicine
Background/Introduction: Cardiopulmonary exercise testing (CPET) is increasingly used for preoperative risk assessment. Evidence to date suggests utility for predicting risk of postoperative morbidity and mortality across a number of surgical specialties (1). It is commonly used to triage patients to postoperative critical care (2) and to inform preoperative risk discussions. We report its use for preoperative collaborative decision making in a large University hepatopancreatobiliary (HPB) surgical unit in which postoperative critical care admission is routine. Methods: Patients undergoing assessment for liver resection and pancreaticoduodenectomy in 2014 and 2015 underwent symptom limited incremental exercise testing at the surgeons’ discretion. Data collected included anaerobic threshold (AT), peak oxygen consumption (peakVO2) and ventilatory equivalents for carbon dioxide at AT (VE/VCO2), clinical plan made on the basis of CPET, intensive care and hospital length of stay (LOS) in operated patients. Based on prior literature, physiological risk was reported to the clinical team as “low risk” (AT > 10mlO2.min-1.kg-1), “high risk” (AT 8-10mlO2.min-1.kg-1) or “very high risk” (AT
2047-0525
Edwards, Mark
818201d5-7636-4292-9af8-7dd8bcd1fcb5
Sharp, Thomas
7f6cbe09-3d04-4d52-9199-db5f2fa154ed
Jack, Sandy
a175e649-83e1-4a76-8f11-ab37ffd954ea
Armstrong, Tom
a41dcf21-0e12-4f37-8e54-3ddcda02d29e
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
Grocott, Michael
1e87b741-513e-4a22-be13-0f7bb344e8c2
Levett, Denny
1743763a-2853-4baf-affe-6152fde8d05f
Edwards, Mark
818201d5-7636-4292-9af8-7dd8bcd1fcb5
Sharp, Thomas
7f6cbe09-3d04-4d52-9199-db5f2fa154ed
Jack, Sandy
a175e649-83e1-4a76-8f11-ab37ffd954ea
Armstrong, Tom
a41dcf21-0e12-4f37-8e54-3ddcda02d29e
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
Grocott, Michael
1e87b741-513e-4a22-be13-0f7bb344e8c2
Levett, Denny
1743763a-2853-4baf-affe-6152fde8d05f

Edwards, Mark, Sharp, Thomas, Jack, Sandy, Armstrong, Tom, Primrose, John, Grocott, Michael and Levett, Denny (2016) [A6 Cardiopulmonary exercise testing for collaborative decision making prior to major hepatobiliary surgery] Proceedings of the American Society for Enhanced Recovery/Evidence Based Peri-Operative Medicine 2016 Annual Congress of Enhanced Recovery and Perioperative Medicine. Perioperative Medicine, 5 (S1). (doi:10.1186/s13741-016-0045-0).

Record type: Meeting abstract

Abstract

Background/Introduction: Cardiopulmonary exercise testing (CPET) is increasingly used for preoperative risk assessment. Evidence to date suggests utility for predicting risk of postoperative morbidity and mortality across a number of surgical specialties (1). It is commonly used to triage patients to postoperative critical care (2) and to inform preoperative risk discussions. We report its use for preoperative collaborative decision making in a large University hepatopancreatobiliary (HPB) surgical unit in which postoperative critical care admission is routine. Methods: Patients undergoing assessment for liver resection and pancreaticoduodenectomy in 2014 and 2015 underwent symptom limited incremental exercise testing at the surgeons’ discretion. Data collected included anaerobic threshold (AT), peak oxygen consumption (peakVO2) and ventilatory equivalents for carbon dioxide at AT (VE/VCO2), clinical plan made on the basis of CPET, intensive care and hospital length of stay (LOS) in operated patients. Based on prior literature, physiological risk was reported to the clinical team as “low risk” (AT > 10mlO2.min-1.kg-1), “high risk” (AT 8-10mlO2.min-1.kg-1) or “very high risk” (AT

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Published date: 5 September 2016

Identifiers

Local EPrints ID: 436999
URI: http://eprints.soton.ac.uk/id/eprint/436999
ISSN: 2047-0525
PURE UUID: 690e1562-4984-4aed-82d2-586c96bba762
ORCID for John Primrose: ORCID iD orcid.org/0000-0002-2069-7605
ORCID for Michael Grocott: ORCID iD orcid.org/0000-0002-9484-7581

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Date deposited: 14 Jan 2020 18:35
Last modified: 13 Dec 2021 03:02

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Contributors

Author: Mark Edwards
Author: Thomas Sharp
Author: Sandy Jack
Author: Tom Armstrong
Author: John Primrose ORCID iD
Author: Michael Grocott ORCID iD
Author: Denny Levett

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