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Predicted Postoperative FEV1 Lung Resection — FRCA Final MCQ

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HardCardiothoracic AnaesthesiaPredicted Postoperative FEV1 Lung ResectionFRCA Final

A patient with severe chronic obstructive pulmonary disease is scheduled for lobectomy for lung cancer. Preoperative spirometry shows FEV1 of 1.2 L (45% predicted). What is the recommended method for predicting postoperative lung function?

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Correct answer: B — Echocardiography to assess RV function

The predicted postoperative (ppo) FEV1 is calculated using the segment counting method: ppo FEV1 = preop FEV1 × (1 - segments removed/total functioning segments). For lobectomy, quantitative perfusion scanning (V/Q) can refine this by weighting the contribution of the resected lobe. A ppo FEV1 <40% predicted or <0.8 L indicates high risk. CPET (VO2 peak) provides additional functional assessment.

Reference: BTS/ESTS – 2023 – Guidelines for radical management of lung cancer: physiological assessment