Predictive value of ventilation efficiency and partial pressure of carbon dioxide at the end of resting moisture in cardiopulmonary complications after lung cancer resection

WEI Lili; SUN Sishan; HAN Jinsheng

doi:10.3969/j.issn.1009-0460.2024.06.014

Abstract：Objective To analyze the value of the slope of VE/VCO2 per minute and the partial pressure of end-tidal carbon dioxide(PetCO2)in predicting cardiopulmonary complications after lung cancer resection.Methods 201 patients with early-stage non-small cell lung cancer who underwent lung resection between March 2020 and November 2023 were collected.All patients underwent pulmonary function examination and cardiopulmonary exercise test before operation.Postoperative cardiopulmonary complications,length of stay(LOS)in the intensive care unit(ICU),hospital LOS,ICU re-admission rate,and mortality were recorded within 30 days after surgery.Results A total of 32 patients with postoperative cardiopulmonary complications were included in the complication group,and the other patients were included in the non-complication group(n=169).The hospital LOS,ICU LOS and ICU re-occupancy rates in the complication group were higher than those in the non-complication group(P＜0.05).Compared with the non-complication group,the resting PetCO2 and VE/VCO2 slopes of the complication group were significantly increased(P＜0.05).Through univariate and multifactorial Logistics analysis,resting PetCO2 and VE/VCO2 slope were independent influencing factors for the occurrence of cardiopulmonary complications after lung cancer resection(P＜0.05).The area under the working characteristic curve of resting PetCO2 for predicting cardiopulmonary complications after lung cancer resection was 0.810(95%CI:0.741-0.880),which was not significantly different from the VE/VCO2 slope[0.795(95%CI:0.720-0.871)].After Spearman rank correlation analysis and multiple linear regression correction,resting PetCO2 was negatively correlated with ICU LOS(P＜0.001)and hospital LOS(P＜0.001).VE/VCO2 slope was positively correlated with ICU LOS(P＜0.001)and hospital LOS(P＜0.001).Conclusion The efficacy of resting PetCO2 and VE/VCO2 slope in predicting cardiopulmonary complications after lung cancer resection is similar,suggesting that resting PetCO2 can be used as a substitute for VE/VCO2 slope in patients who are unable or unwilling to receive CPET.