Required Tests for Lung Volume Reduction Surgery (LVRS)

Day 1:

- Complete set of pulmonary function test (PFT), including spirometry, lung volumes, maximum inspiratory & expiratory pressure (MIP & MEP), diffusion capacity (DLCO), Carboxy Hgb and Hgb.

- 6 minute walk test

- Room air arterial blood gases (ABG)

- Chest X-ray

- High resolution chest CT scan (HRCT)

- Quantitative lung perfusion scan (LPQ)

Day 2:

- 2D echocardiography

- Cardio-pulmonary exercise test with VO2 measurement

- Labs (Chem7, CBC) and cotinine level

- Visit with the pulmonary specialist and program manager for clinical evaluation and discussion about pulmonary rehabilitation

Pulmonary Rehabilitation

- 6-10 weeks (16-20 sessions) of pulmonary rehab consisting of 3 days per week of exercise, education and behavioral modification. The first 3 sessions and the last session prior to the surgery, including an exit evaluation will be done at the OSU Medical Center. The other sessions of rehab can be arranged at one of the facilities approved by OSU. Patients are also required to exercise for 2 additional days at home and document their progress.

Other appointments scheduled during the course of rehab

- Visit with the surgeon

- Visit with the behaviorist

- Dobutamine stress test to evaluate heart function during the course of rehab

- Visit with the cardiologist and heart catherization only if necessary based on the stress test findings

Post Rehab and Pre-op Tests 

- Complete set of PFT’s, lung volumes, MIP & MEP, Carboxy Hgb and Hgb

- 6 MW

- Room air ABG’s 

- Cardio-pulmonary exercise test

- Visit with the surgeon to review the rehab and test results and final discussions regarding the surgery

- CXR and labs (scheduled by the surgery department)

* Note: All pulmonary function tests are done post bronchodilator

Post LVRS Requirements

- Follow-up visit with the surgeon

- Resume pulmonary rehab, 1st session to be done at OSU. Total of 6-10 sessions post-op are covered per insurance, the remaining 9 sessions could be done at OSU or the approved facility at 2 days per week. Patients are required to continue exercising another 2-3 days at home or in a maintenance program. 

- Visit with the pulmonary specialist to review medications and oxygen requirements

- Patients are encouraged to stay in a maintenance exercise program of 3-5 days per week

Scheduled Follow-up Visits

- 6 month FU visit including a visit with the pulmonary specialist, PFT’s, including lung volumes and DLCO, 6MW, RA ABG, CXR (chest CT scan if necessary)

- One Year FU visit with the pulmonary specialist, all the above tests and a cardio-pulmonary exercise test