Prueba de caminata de 6 minutos/Six-minute walk test

La prueba preoperatoria de caminar 6 minutos no predice complicaciones pulmonares en cirugía de abdomen alto


Preoperative 6-min walking distance does not predict pulmonary complications in upper abdominal surgery.
Paisani DM, Fiore JF Jr, Lunardi AC, Colluci DB, Santoro IL, Carvalho CR, Chiavegato LD, Faresin SM.
Respiratory Department, Federal University of São Paulo, São Paulo, Brazil. denipaisani@yahoo.com.br
Respirology. 2012 Aug;17(6):1013-7. doi: 10.1111/j.1440-1843.2012.02202.x.
Abstract
BACKGROUND AND OBJECTIVE:Field exercise tests have been increasingly used for pulmonary risk assessment. The 6-min walking distance (6MWD) is a field test commonly employed in clinical practice; however, there is limited evidence supporting its use as a risk assessment method in abdominal surgery. The aim was to assess if the 6MWD can predict the development of post-operative pulmonary complications (PPCs) in patients having upper abdominal surgery (UAS)......CONCLUSIONS:The results of the present study suggest that the 6-min walking test is not a useful tool to identify subjects with increased risk of developing PPC following UAS.
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1843.2012.02202.x/pdf



Validez de la prueba de caminata de 6 minutos en la predicción del umbral anaeróbico antes de la cirugía mayor no cardíaca.

Validity of the 6 min walk test in prediction of the anaerobic threshold before major non-cardiac surgery.

Sinclair RC, Batterham AM, Davies S, Cawthorn L, Danjoux GR.

Department of Anaesthesia, The James Cook University Hospital, Middlesbrough, UK. rhona.sinclair@ncl.ac.uk

Br J Anaesth. 2012 Jan;108(1):30-5. doi: 10.1093/bja/aer322. Epub 2011 Oct 5.

Abstract

BACKGROUND:For perioperative risk stratification, a robust, practical test could be used where cardiopulmonary exercise testing (CPET) is unavailable. The aim of this study was to assess the utility of the 6 min walk test (6MWT) distance to discriminate between low and high anaerobic threshold (AT) in patients awaiting major non-cardiac surgery. METHODS:In 110 participants, we obtained oxygen consumption at the AT from CPET and recorded the distance walked (in m) during a 6MWT. Receiver operating characteristic (ROC) curve analysis was used to derive two different cut-points for 6MWT distance in predicting an AT of <11 ml O(2) kg(-1) min(-1); one using the highest sum of sensitivity and specificity (conventional method) and the other adopting a 2:1 weighting in favour of sensitivity. In addition, using a novel linear regression-based technique, we obtained lower and upper cut-points for 6MWT distance that are predictive of an AT that is likely to be (P≥0.75) <11 or >11 ml O(2) kg(-1) min(-1). RESULTS:The ROC curve analysis revealed an area under the curve of 0.85 (95% confidence interval, 0.77-0.91). The optimum cut-points were <440 m (conventional method) and <502 m (sensitivity-weighted approach). The regression-based lower and upper 6MWT distance cut-points were <427 and >563 m, respectively. CONCLUSIONS:Patients walking >563 m in the 6MWT do not routinely require CPET; those walking <427 m should be referred for further evaluation. In situations of 'clinical uncertainty' (≥427 but ≤563 m), the number of clinical risk factors and magnitude of surgery should be incorporated into the decision-making process. The 6MWT is a useful clinical tool to screen and risk stratify patients in departments where CPET is unavailable.

http://bja.oxfordjournals.org/content/108/1/30.full.pdf


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Anestesiología y Medicina del Dolor
www.anestesia-dolor.org