Perrotta F, Cennamo A, Cerqua FS, Stefanelli F, Bianco A, Musella S, Rispoli M, Salvi R, Meoli I.

J Bras Pneumol. 2019 Oct 14;45(6):e20180132. doi: 10.1590/1806-3713/e20180132

OBJECTIVE: Preoperative functional evaluation is central to optimizing the
identification of patients with non-small cell lung cancer (NSCLC) who are
candidates for surgery. The minute ventilation/carbon dioxide output (VE/VCO2)
slope has proven to be a predictor of surgical complications and mortality.
Pulmonary rehabilitation programs (PRPs) could influence short-term outcomes in
patients with COPD undergoing lung resection. Our objective was to evaluate the
effects of a PRP on the VE/VCO2 slope in a cohort of patients with COPD
undergoing lung resection for NSCLC.
METHODS: We retrospectively evaluated 25 consecutive patients with COPD
participating in a three-week high-intensity PRP prior to undergoing lung surgery
for NSCLC, between December of 2015 and January of 2017. Patients underwent
complete functional assessment, including spirometry, DLCO measurement, and
cardiopulmonary exercise testing.
RESULTS: There were no significant differences between the mean pre- and post-PRP
values (% of predicted) for FEV1 (61.5 ± 22.0% vs. 62.0 ± 21.1%) and DLCO (67.2 ±
18.1% vs. 67.5 ± 13.2%). Conversely, there were significant improvements in the
mean peak oxygen uptake (from 14.7 ± 2.5 to 18.2 ± 2.7 mL/kg per min; p < 0.001)
and VE/VCO2 slope (from 32.0 ± 2.8 to 30.1 ± 4.0; p < 0.01).
CONCLUSIONS: Our results indicate that a high-intensity PRP can improve
ventilatory efficiency in patients with COPD undergoing lung resection for NSCLC.
Further comprehensive prospective studies are required to corroborate these
preliminary results.