Validation of a Noninvasive Assessment of Pulmonary Gas Exchange During Exercise in Hypoxia
Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Pulmonary gas exchange efficiency, determined by the alveolar-to-arterial Po2 difference (A-aDo2), progressively worsens during exercise at sea-level; this response is further elevated during exercise in hypoxia. Traditionally, pulmonary gas exchange efficiency is assessed through measurements of ventilation and end-tidal gases paired with direct arterial blood gas (ABG) sampling. Because these measures have a number of caveats, particularly invasive blood sampling, the development of new approaches for the noninvasive assessment of pulmonary gas exchange is needed.
RESEARCH QUESTION: Is a noninvasive method of assessing pulmonary gas exchange valid during rest and exercise in acute hypoxia?.
STUDY DESIGN AND METHODS: Twenty-five healthy participants (10 female) completed a staged maximal exercise test on a cycle ergometer in a hypoxic chamber (Fio2 = 0.11). Simultaneous ABGs via a radial arterial catheter and noninvasive gas-exchange measurements (AGM100) were obtained in 2-minute intervals. Noninvasive gas exchange, termed the O2 deficit, was calculated from the difference between the end-tidal and the calculated Pao2 (via pulse oximetry and corrected for the Bohr effect by using the end-tidal Pco2). Noninvasive O2 deficit was compared with the traditional alveolar to arterial oxygen difference (A-aDo2), using the traditional Riley analysis.
RESULTS: Under conditions of rest at room air, hypoxic rest, and hypoxic exercise, strong correlations between the calculated gPao2 and directly measured Pao2 (R2 = 0.97; P < .001; mean bias = 1.70 mm Hg) were observed. At hypoxic rest and exercise, strong relationships between the estimated and directly measured Pao2 (R2 = 0.68; P < .001; mean bias = 1.01 mm Hg) and O2 deficit with the traditional A-aDo2 (R2 = 0.70; P < .001; mean bias = 5.24 mm Hg) remained.
INTERPRETATIONS: Our findings support the use of a noninvasive measure of gas exchange during acute hypoxic exercise in heathy humans. Further studies are required to determine whether this approach can be used clinically as a tool during normoxic exercise in patients with preexisting impairments in gas exchange efficiency.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:158 |
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| Enthalten in: |
Chest - 158(2020), 4 vom: 20. Okt., Seite 1644-1650 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Howe, Connor A [VerfasserIn] |
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| Links: |
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| Themen: |
Exercise |
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| Anmerkungen: |
Date Completed 03.06.2021 Date Revised 03.06.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.chest.2020.04.017 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM309279097 |
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| 520 | |a Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Pulmonary gas exchange efficiency, determined by the alveolar-to-arterial Po2 difference (A-aDo2), progressively worsens during exercise at sea-level; this response is further elevated during exercise in hypoxia. Traditionally, pulmonary gas exchange efficiency is assessed through measurements of ventilation and end-tidal gases paired with direct arterial blood gas (ABG) sampling. Because these measures have a number of caveats, particularly invasive blood sampling, the development of new approaches for the noninvasive assessment of pulmonary gas exchange is needed | ||
| 520 | |a RESEARCH QUESTION: Is a noninvasive method of assessing pulmonary gas exchange valid during rest and exercise in acute hypoxia? | ||
| 520 | |a STUDY DESIGN AND METHODS: Twenty-five healthy participants (10 female) completed a staged maximal exercise test on a cycle ergometer in a hypoxic chamber (Fio2 = 0.11). Simultaneous ABGs via a radial arterial catheter and noninvasive gas-exchange measurements (AGM100) were obtained in 2-minute intervals. Noninvasive gas exchange, termed the O2 deficit, was calculated from the difference between the end-tidal and the calculated Pao2 (via pulse oximetry and corrected for the Bohr effect by using the end-tidal Pco2). Noninvasive O2 deficit was compared with the traditional alveolar to arterial oxygen difference (A-aDo2), using the traditional Riley analysis | ||
| 520 | |a RESULTS: Under conditions of rest at room air, hypoxic rest, and hypoxic exercise, strong correlations between the calculated gPao2 and directly measured Pao2 (R2 = 0.97; P < .001; mean bias = 1.70 mm Hg) were observed. At hypoxic rest and exercise, strong relationships between the estimated and directly measured Pao2 (R2 = 0.68; P < .001; mean bias = 1.01 mm Hg) and O2 deficit with the traditional A-aDo2 (R2 = 0.70; P < .001; mean bias = 5.24 mm Hg) remained | ||
| 520 | |a INTERPRETATIONS: Our findings support the use of a noninvasive measure of gas exchange during acute hypoxic exercise in heathy humans. Further studies are required to determine whether this approach can be used clinically as a tool during normoxic exercise in patients with preexisting impairments in gas exchange efficiency | ||
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| 650 | 4 | |a Validation Study | |
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| 650 | 4 | |a hypoxia | |
| 650 | 4 | |a noninvasive | |
| 650 | 4 | |a pulmonary gas exchange | |
| 650 | 4 | |a validation | |
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| 700 | 1 | |a Wainman, Liisa |e verfasserin |4 aut | |
| 700 | 1 | |a Oliver, Samuel J |e verfasserin |4 aut | |
| 700 | 1 | |a Ainslie, Philip N |e verfasserin |4 aut | |
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