Pulmonary Function Testing and Preoperative Assessment

Pulmonary function testing (PFT), namely, forced expiratory volume in 1 s (FEV1) and diffusion capacity of the lung for carbon monoxide (DLCO), remains the primary determinant of operative risk for patients undergoing pulmonary resection. Exercise testing with stair climbing or formal measurement of oxygen consumption (VO2max) is helpful in determining eligibility for surgery in patients with diminished PFTs. The thoracic revised cardiac risk index is used to identify patients at risk for postoperative cardiac morbidity and thus help select patients requiring further preoperative cardiac testing and optimization.