Timed stair climbing to 20 m altitude identifies lung resection candidates with high exercise capacity

Ref ID: 18409

Author:

Maurizio Bernasconi, David Maree, Coenraad Koegelenberg, Florian von
Groote-Bidlingmaier, Andreas Diacon, Chris Bolliger.

Author address:

Division of Pulmonology,
Department of Medicine, Tygerberg Academic Hospital, University of
Stellenbosch, Cape Town, Western Cape, South Africa

Full conference title:

European Respiratory Congress

Abstract:

Background: Clinical evaluation for lung resection includes assessment of
pulmonary function and maximum oxygen uptake (VO2max). A VO2max of
20ml/kg/min is considered sufficient for pneumonectomy. Stair climbing as a
low-cost alternative to formal treadmill cardiopulmonary exercise testing (CPET),
is attractive but lacks standardisation.
Methods: We asked 40 lung resection candidates (bronchiectasis or aspergilloma,
n=31; lung cancer, n=7; hydatid cyst, n=2) with FEV1 and/or DLCOc <80% predicted (mean age: 43.7y; mean FEV1: 49.7%; mean DLCOc: 56.9%; 30 pts with FEV1/FVC <70%) to climb to a maximum of 20m elevation as high and as fast as they could. Time of ascent to 20m and elevation reached were measured. Peak VO2 achieved during stair climbing and CPET were compared (MetaMax II, Cortex, Germany). Results: Mean elevation reached was 17.2m.Mean peak VO2 during stair climbing was very similar to that during CPET (23.5 vs. 23.6ml/min/kg, p=0.87). Twentyfour patients (60%) reached 20m. There was a good linear correlation between speed of ascent and peak VO2 (r=0.63 for stair climbing and 0.67 for CPET), but 4 of those patients (17%) remained below a peak VO2 of 20ml/kg/min. However, all 16 patients (67%) who reached 20m and climbed with a speed of >15m/min
had a VO2 peak of >20ml/min/kg during stair climbing and CPET. No patient
with a FEV1 <40% could climb to 20m or ascend faster than >15m/min.
Conclusions: Speed of ascent of >15m/min accurately identifies patients with
a peak VO2 of >20ml/min/kg, thereby obviating the need for CPET in those
patients.

Abstract Number: 1912

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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