You are evaluating a 50 year old smoker for lung resection for localized non-small cell lung cancer. Pre-operative pulmonary function tests include: FEV1 1.8 L, 75% of predicted, preoperative DLCO 90%, predicted post-operative FEV1 is 900mL or 45% of predicted.Challenge: What is your interpretation of this data?
Image of pneumonectomy shown under Creative Commons Attribution Share-Alike License, from Wikipedia.
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Pre-Op II
For patients undergoing pneumonectomy, if the pre-operative FEV1 is >2L or >80% and DLCO is >80%, then it is acceptable to proceed with surgery. Since this patient’s FEV1 is <2L and <80%, post-operative values are calculated based on quantitative perfusion, ventilation, or CT scan. A post-operative FEV1 >800cc or >40% predicted is acceptable.
Source: UpToDate.
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