Outcomes of lung volume reduction surgery patients with high flow oxygen requirements (Greater than 4 liters oxygen)

Purpose: Do patients with high flow oxygen requirements who undergo Lung Volume Reduction Surgery (LVRS) have changes in oxygen requirements following bilateral LVRS via median sternotomy. Methods: A retrospective review was conducted on a group of patients with COPD who required ≥ 4 Liters (L) oxygen with exercise prior to LVRS. Twenty- five patients 17 males, 8 females with COPD accepted for LVRS with a mean age of 61; were reviewed from evaluation to 1 year post LVRS. Interventions: Patients were tested at evaluation, preop, 6 months (mos) and 1 year. Data collected included 6 minute walk (6MW), O₂ requirements at rest and with exercise, FEV₁ and FEV₁ % of predicted. All patients exercised a minimum of 6 weeks prior to surgery. Results: Eval Preop 6 mos 1 yr % on O₂ ex (L) 100% (5.0 L) 96% (5.0 L) 48% (5.0 L) 60% (4.0 L) % on O₂ rest (L) 60% (2.0 L) 68% (2.5 L) 20% (2.0 L) 24% (2.5 L) 6 MW (ft) 885 1122 1371 1341 FEV₁ .67 .69 1.12 .97 FEV₁ % 22% 22% 38% 33% Conclusions: The primary goal of LVRS is to improve function and quality of life. Many patients can eliminate their O₂ requirements post op but a significant number continue to require similar amounts of O₂ in spite of improvements in their 6 MW test and measured pulmonary function. Clinical Implications: In this group of LVRS patients the percentage requiring O₂ did decrease after LVRS. Their FEV1, FEV1 % of predicted and 6 MW distance increase postoperatively.