Chest
Clinical Investigations: ExerciseComparison of Pulmonary Gas Exchange Measurements Between Incremental and Constant Work Exercise Above the Anaerobic Threshold
Section snippets
Materials and Methods
Sixteen patients (11 men and 5 women) and 9 normal men were studied in the human performance laboratory of the William Beaumont Army Medical Center at an altitude of 1,270 m (barometric pressure, 656 mm Hg). The ABG and pulmonary gas exchange data from the nine normal subjects were extracted from a previous study.20 The data of the 16 patients were obtained from clinical cardiopulmonary exercise tests performed in patients referred to our laboratory for evaluation of dyspnea on exertion and/or
Results
Pulmonary function test results and anthropometric characteristics are summarized in Table 1 for both study groups (mean±SEM, and percent predicted values). The normal group consisted of healthy young men, with normal spirometry, lung volumes, and diffusing capacity. In the patients, the resting pulmonary function test results varied from normal to severely abnormal. For the patient group, the range of percent predicted values is presented to emphasize the fact that patients with varying
Discussion
Automated systems that use breath-by-breath analysis have facilitated the measurement of cardiopulmonary and pulmonary gas exchange variables during incremental exercise.25 However, sufficient uncertainty persists regarding the assumptions involved in the application of the mass balance equation in each breath during IET to warrant clinical validation of pulmonary gas exchange measurements using breath-by-breath analysis. There is a well-established variability in gas exchange values measured
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2001, Clinics in Chest MedicineCitation Excerpt :Corroboration of incremental results may be achieved with ABG measurement during a 6-minute constant work exercise test at 60% to 70% of the maximum work achieved (≃ 90% o2peak). Recently, validation of pulmonary gas exchange measurements during IET above the AT has been reported.133 Abnormal widening of P(A-a)o2 with exercise usually reflects ventilation-perfusion ratio (/) mismatching but also can be caused by diffusion abnormalities, anatomic shunt, or reduced oxygen saturation in mixed venous blood worsening the / mismatching (shunt effect).119
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The opinions or assertions contained herein are the private view of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. The investigators have adhered to the policies for protection of human subjects as prescribed in 40 CFR 46.