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Cardiopulmonary Exercise Testing (CPEX)

Cardiopulmonary Exercise Testing (CPEX). Dr David Timbrell Vascular Anaesthetic Fellow AAA QIP Meeting, Hayward’s Heath 30 March 2012. CPEX at Frimley. Established Summer 2010 Initially colorectal Increasing vascular caseload last 6-12 months 3 cases/day 1hr each History, test, feedback.

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Cardiopulmonary Exercise Testing (CPEX)

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  1. Cardiopulmonary Exercise Testing (CPEX) Dr David Timbrell Vascular Anaesthetic Fellow AAA QIP Meeting, Hayward’s Heath 30 March 2012

  2. CPEX at Frimley • Established Summer 2010 • Initially colorectal • Increasing vascular caseload last 6-12 months • 3 cases/day • 1hr each • History, test, feedback

  3. AAA Caseload • 1/1/11 – 31/1/12 (13 months) • National Vascular Database

  4. AAA Caseload

  5. Who to CPEX? • All planned Open repair • Patients ? Open, ? EVAR • EVAR according to Red, Amber, Green score • Not capacity for all EVAR

  6. CPEX Caseload • 53 AAA patients since established • 48 planned open/unsure • 2 TEVAR • 3 planned EVAR • 20 proceeded to open • 12 proceeded to EVAR • Remaining 21 patients • 3 Referred to St George’s • 12 Surgery awaited • 6 Not to proceed, deceased etc

  7. Can CPEX help us to fast-track Open AAA patients? • 11/20 patients AT > 11 ml/kg/min • What support was required?

  8. Outcomes – ITU Support • Median discharge day 3 vs 4

  9. Future Plans • CPEX for all Open AAA patients • Vascular Anaesthesia Clinic • For all EVAR pts • ? Extended recovery/HDU for elective open AAA pts with AT > 11 • Assuming no complications

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