Cardiopulmonary exercise testing for perioperative risk stratification in various surgeries. Literature review.

Simona Ripkauskaitė1, Raimundas Karčauskas1, Vilius Ripkauskas1

1 Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania


Cardiopulmonary exercise testing (CPET) remains the gold standard for measuring the function of the cardiorespiratory system and assessing individual functional capacity. CPET could be used to differentiate causes of exercise intolerance and unexplained dyspnoea, to evaluate the severity of heart failure and impairment caused by COPD. Comorbid diseases, cardiovascular illnesses and functional capacity disorders could predispose patients to adverse surgical outcomes. Accurate risk stratification would identify those patients who have higher postoperative complications risk after specific surgical interventions. Some authors revealed that there is association between low functional capacity determined by CPET and patient outcomes after cardiopulmonary and non-cardiopulmonary surgery. Therefore CPET is becoming more often used as a preoperative risk stratification tool for various surgeries. Data obtained during CPET helps to determine the extent of surgery, perioperative management strategy and choice of postoperative care. The aim of this literature review is to analyze cardiopulmonary exercise testing capabilities in determining the preoperative risk of general surgery. We focused on evaluating the capacity of CPET variables to predict the risk of postoperative complications and mortality in comparison to other methods used for risk assessment.

Keywords: cardiopulmonary exercise testing, perioperative risk, functional capacity.