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The Proceedings of the American Thoracic Society 5:427-431 (2008)
© 2008 The American Thoracic Society
doi: 10.1513/pats.200707-087ET
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The Evaluation and Preparation of the Patient for Lung Volume Reduction Surgery

Malcolm M. DeCamp, Jr.1, David Lipson2, Mark Krasna3, Omar A. Minai4, Robert J. McKenna, Jr.5 and Byron M. Thomashow6

1 Beth Israel Deaconess Medical Center, Boston, Massachusetts; 2 University of Pennsylvania Medical Center, Philadelphia, Pennsylvania; 3 St. Joseph's Medical Center, Towson, Maryland; 4 Cleveland Clinic Foundation, Cleveland, Ohio; 5 Cedars-Sinai Medical Center, Los Angeles, California; 6 Columbia-Presbyterian Medical Center, New York, New York

Correspondence and requests for reprints should be addressed to Byron M. Thomashow, M.D., Columbia-Presbyterian Medical Center, Herbert Irving Pavilion, Suite 311, 161 Fort Washington Avenue, New York, NY 10032. E-mail: bmt1{at}columbia.edu

ABSTRACT

Potential candidates for lung volume reduction surgery should undergo extensive evaluation and preparation to minimize perioperative risks and optimize surgical outcomes. Initial screening includes spirometry, diffusion capacity, lung volumes by body plethysmography, and high-resolution computerized tomography scanning. Patients who have been successfully screened must complete a preoperative pulmonary rehabilitation program of 6–10 weeks duration. During the pulmonary rehabilitation program, medical therapy should be maximized. Postrehabilitation studies include cardiopulmonary exercise testing, arterial blood gas analysis, oxygen titration, six-minute walk, and cardiac testing. The evaluation process aims at defining the severity and distribution of emphysema and attempts to eliminate those who do not meet criteria outlined by the National Emphysema Treatment Trial. Optimal candidates have upper-lobe–predominant emphysema and acceptable operative risks.

Key Words: preoperative evaluation • lung volume reduction surgery • emphysema • pulmonary rehabilitation • chronic obstructive pulmonary disease


Related articles in Proceedings of the American Thoracic Society:

Lung Volume Reduction Surgery: Technique, Operative Mortality, and Morbidity
Malcolm M. DeCamp, Jr., Robert J. McKenna, Jr., Claude C. Deschamps, and Mark J. Krasna
Proceedings of the American Thoracic Society 2008 5: 442-446. [Abstract] [Full Text]  



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M. M. DeCamp Jr., R. J. McKenna Jr., C. C. Deschamps, and M. J. Krasna
Lung Volume Reduction Surgery: Technique, Operative Mortality, and Morbidity
Proceedings of the ATS, May 1, 2008; 5(4): 442 - 446.
[Abstract] [Full Text] [PDF]


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