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

Kód výsledku v 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>

Nalezeny alternativní kódy

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

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30212 - Surgery

Projekt

<a href="/cs/project/NU21-06-00086" target="_blank" >NU21-06-00086: Trénink dechových svalů jako způsob pre-habilitace před plicním resekčním zákrokem</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

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

Název periodika

British journal of anaesthesia

ISSN

0007-0912

e-ISSN

1471-6771

Svazek periodika

135

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

PT - Portugalská republika

Počet stran výsledku

9

Strana od-do

188-196

Kód UT WoS článku

001518614700008

EID výsledku v databázi Scopus

2-s2.0-105005511206