Clinical Research Directory

Simplified Exercise-based Risk Assessment in Lung Cancer

Physiological evaluation is part of the preoperative risk estimation in patients with lung cancer, and it aids in the choice of treatment. Ventilatory efficiency during exercise has emerged as a strong predictor of major postoperative complications, so far determined during a maximal cardiopulmonary exercise test. However, this test is limited by its availability and high cost, due to the requirement of high-technological equipment and advanced expertise. The current project aims to evaluate a simplified and accessible method for risk evaluation before decision on treatment in lung cancer. It builds on recent advances in technology and knowledge and combines a simple, low-intensity cycling test with measurement of ventilatory efficiency (end-tidal carbon dioxide pressure) with a handheld monitor. In a prospective, multi-center design the investigators will include patients evaluated for suspected lung cancer. The main objective is to establish threshold values for end-tidal carbon dioxide associated with low respectively high risk of major complications in patients undergoing surgery. In addition, the study aims to determine if end-tidal carbon dioxide can predict severe side-effects during neoadjuvant or curatively aiming systemic therapy. The project is closely linked to clinical practice, and the results can be easily implemented due to the simple and cost-efficient methodology. the suggested simplified approach would also allow access to physiological evaluation where more advanced methods are unavailable.

Test-Retest Reliability And Validation For End-Tidal Carbon Dioxide Measurement (PetCO2) During Rest And Low-Loaded Steady State Work Using A Portable Capnograph.

The goal of this observational study is to investigate exhaled carbon dioxide measuring during rest and low-loaded work using a portable device (capnograph) and standard of care apparatus during a cardiopulmonary exercise test (CPET) in healthy volunteers. The study aims to answer: How reliable is exhaled end-tidal carbon dioxide measurement for an individual over time using both standard of care apparatus and a portable device during an ergometer test? Do the measurements correlate between the portable device and standard of care apparatus? How do changes in breathing instructions and placement of sampling cannula affect the measurements from the portable device (capnograph)? How is the reliability over time of other well established values from a cardio pulmonary exercise test? Participants will be asked to perform a modified cardiopulmonary exercise test on an ergometer twice, separated in time (1-4 weeks). Measurements are sampled alternating standard of care apparatus and a portable capnograph at rest and during low-loaded work.