ABSTRACT
Preop 1. Preoperative assessment is focused on whether or not the patient has the pul
monary reserve to withstand removal of the lobe. Two tests are used for this purpose: pulmonary function tests (PFTs) and the arterial blood gas (ABG). Based upon preoperative PFTs, the patient must generally have a postoperative predicted forced expiratory volume in 1 second (FEV1.0) or diffusing capacity (DLCO) of at least 40% of the corresponding value according to age, height and gender. Predicted postoperative function = preoperative function x [1-(Functional segments to be resected/Total number of functional segments)] A quick rule of thumb assigns a loss of function of 5.2 6% per functional segment removed. Patients with predicted postoperative DLCO or FEV1 <40% are at higher risk for pulmonary failure and death.
