Lung Volume Reduction Screening Process
In order to determine if you will be a good surgical candidate for lung volume reduction, you will be put through a very thorough testing and screening process. The screening process will include medical, surgical and smoking histories. Testing will include a high resolution CT scan, quantitative lung perfusion scan, chest X-ray, complete pulmonary function tests before and after bronchodilator, arterial blood gases, plasma cotinine level, exercise stress test, 12 lead EKG, echocardiogram, and a dobutamine stress test of the heart.
You will meet with the LVRS team pulmonologist and the LVRS team coordinator for screening and education. While you are going through the screening and evaluation process, you will also be enrolled in outpatient pulmonary rehabilitation. Depending on certain test results, you may also need to be evaluated by a cardiologist before being approved for surgery. After testing and evaluation, if you are found to be a good surgical candidate, you will then meet with the LVRS team surgeon for final evaluation and scheduling of your surgery.
Pulmonary rehabilitation is required of all patients considering lung volume reduction surgery. Pre-operatively, patients must complete 20 sessions of pulmonary rehab. Patients will also receive rehab during their immediate post-operative hospital stay. After discharge from the hospital, all LVRS patients must complete 6-8 more sessions of pulmonary rehabilitation. This is usually started within the first week of discharge from the hospital. Pulmonary rehabilitation can be completed at Lutheran Hospital or another pulmonary rehab facility as long as that facility meets national standards.
Any patient being evaluated for lung volume reduction surgery must go through an extensive pre-operative screening process. Initial testing needed to determine if a patient is an appropriate surgical includes a CT scan, a VQ scan, a pulmonary function test, and a cycle ergometry ( a test to determine exercise tolerance). These tests are performed at Lutheran Hospital. Laboratory studies are also done in the early screening process. These tests include arterial blood gases and a test to determine if patients are smoke-free. If all preliminary screening and testing reveals that the patient may be a good candidate for lung volume reduction, they then begin the final testing phase. This includes an EKG, an echocardiogram, and a cardiac stress test. If a patient passes this final phase of testing, they are then considered a good candidate for lung volume reduction surgery.