Multimodal prehabilitation before lung resection surgery: a multicentre randomised controlled trial

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00209805%3A_____%2F25%3A00080271" target="_blank" >RIV/00209805:_____/25:00080271 - isvavai.cz</a>

Alternative codes found

RIV/00216224:14110/25:00141741 RIV/65269705:_____/25:00082120 RIV/00098892:_____/25:10159314 RIV/00159816:_____/25:00082443 RIV/61989592:15110/25:73636179

Result on the web

<a href="https://www.sciencedirect.com/science/article/pii/S0007091225001965?via%3Dihub" target="_blank" >https://www.sciencedirect.com/science/article/pii/S0007091225001965?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.bja.2025.03.018" target="_blank" >10.1016/j.bja.2025.03.018</a>

Result language

angličtina

Original language name

Multimodal prehabilitation before lung resection surgery: a multicentre randomised controlled trial

Original language description

BACKGROUND: Respiratory muscle training may improve ventilatory efficiency (V(E)/VCO(2) slope), a strong predictor of postoperative pulmonary complications. We hypothesised that multimodal prehabilitation, incorporating high-intensity respiratory muscle training, before lung resection would reduce postoperative complications and length of hospital stay. METHODS: We conducted a prospective multicentre, randomised controlled trial (NCT04826575) to examine the effect of prehabilitation in individuals undergoing lung resection. Participants were defined as high-risk for postoperative pulmonary complications if they achieved V(E)/VCO(2) slope GREATER-THAN OR EQUAL TO33, as determined by cardiopulmonary exercise testing. Participants were then randomised to either usual care or multimodal prehabilitation, which consisted of a 14-day programme of high-intensity respiratory muscle training, smoking cessation, nutritional support, and psychological support. The primary outcome were postoperative pulmonary and cardiovascular complications (pneumonia, atelectasis, respiratory failure necessitating mechanical ventilation, adult respiratory distress syndrome, prolonged air leak). RESULTS: A total of 122 patients (46% female; age range: 64-75 yr) completed the study. Postoperative pulmonary complications occurred in 20/58 (34%) of patients randomised to multimodal prehabilitation, compared with 35/64 (55%) patients receiving usual care (odds ratio 2.29 [95% confidence interval 1.10-4.77]; P=0.029). Hospital length of stay was shorter after multimodal rehabilitation (9 days [7-11]), compared with patients randomised to receive usual care (7 days [6-9]; P=0.038). After prehabilitation, mean (sd) V(E)/VCO(2) slope decreased from 39 (8) to 36 (9); P=0.01. Prehabilitation also improved patient-reported quality of life measures. CONCLUSIONS: In high-risk patients undergoing elective lung resection surgery, multimodal prehabilitation, including high-intensity respiratory muscle training to target V(E)/VCO(2), reduced postoperative pulmonary complications and hospital length of stay.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30212 - Surgery

Project

<a href="/en/project/NU21-06-00086" target="_blank" >NU21-06-00086: High intensity respiratory muscle training as a pre-habilitation in lung surgery candidates</a><br>

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

British journal of anaesthesia

ISSN

0007-0912

e-ISSN

1471-6771

Volume of the periodical

135

Issue of the periodical within the volume

1

Country of publishing house

PT - PORTUGAL

Number of pages

9

Pages from-to

188-196

UT code for WoS article

001518614700008

EID of the result in the Scopus database

2-s2.0-105005511206