Comparison between measured and fick-derived values of hemodynamic and oxymetric variables in patients with acute myocardial infarction

Iparraguirre, Horacio Pomés; Giniger, Rodolfo; Garber, Victor; Quiroga, Edgardo; Jorge, Miguel A.

doi:10.1016/0002-9343(88)90585-2

Cited by 16 publications

(5 citation statements)

References 15 publications

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“…Although direct spirometry is the most accurate mode of measuring gas exchange, this equipment is expensive and not often available in general rehabilitation centers which could potentially limit access and delay time to prosthetic fitting. However, a comparison of indirect estimation of VO 2 to direct measurement in the population with LEA using the Fick equation or similar validated method could greatly increase access to testing as many physical therapy clinics have at least one of the modality types mentioned in this review [ 31 , 32 ]. The dependence of this review and CPG on direct spirometry limits the clinical applicability at this time.…”

Section: Discussionmentioning

confidence: 99%

The role of exercise testing in predicting successful ambulation with a lower extremity prosthesis: a systematic literature review and clinical practice guideline

Klenow¹,

Mengelkoch

Stevens

et al. 2018

J NeuroEngineering Rehabil

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BackgroundGrowing discontent with the k-level system for functional classification of patients with limb loss and movement of healthcare toward evidence-based practice has resulted in the need for alternative forms of functional classification and development of clinical practice guidelines to improve access to quality prosthetic interventions. The purpose of this project was to develop and present a clinical practice recommendation for exercise testing in prosthetic patient care based on the results and synthesis of a systematic literature review.MethodsDatabase searches of PubMed, Google Scholar, Web of Science, and Cochrane were conducted and articles reviewed. Of the potential 1386 articles 10 met the criteria for inclusion. These articles were assessed using the critical appraisal tool of the United Kingdom National Service Framework for Long-Term Conditions. Of the 10 included articles eight were of high, one of medium, and one of low, quality. Data from these articles were synthesized into 6 empirical evidence statements, all qualifying for research grade A. These statements were used to develop the proposed clinical practice guideline.ResultsWhile the results of this systematic review were not able to support the direct connection between cardiorespiratory performance and K-levels, the literature did support the ability of exercise testing results to predict successful prosthetic ambulation in some demographics. Both continuous maximum-intensity single lower extremity ergometer propelled by a sound limb and intermittent submaximal upper extremity ergometer protocols were found to be viable evaluation tools of cardiorespiratory fitness and function in the target population.ConclusionThe ability to sustain an exercise intensity of ≥50% of a predicted VO2max value in single leg cycle ergometry testing and achievement of a sustained workload of 30 W in upper extremity ergometry testing were found to be the strongest correlates to successful ambulation with a prosthesis. VO2 values were found to increase in amputee subjects following a 6-week exercise program. These synthesized results of the systematic literature review regarding exercise testing in patients with loss of a lower extremity were used to develop and a present a clinical treatment pathway.Electronic supplementary materialThe online version of this article (10.1186/s12984-018-0401-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The role of exercise testing in predicting successful ambulation with a lower extremity prosthesis: a systematic literature review and clinical practice guideline

Klenow¹,

Mengelkoch

Stevens

et al. 2018

J NeuroEngineering Rehabil

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“…While oxygen demand may be above basal requirements early in the course of uncomplicated AMI, owing to a high plasma catecholamine concentration (Rady et al, 1993), the key overall finding is a down-regulation of oxygen demand which probably reflects a metabolic cellular adaptive response to the challenge of a diminished supply. In all of the reviewed studies, IVO 2 was calculated by means of the Fick equation, which has shown a persistent, strong correlation with measurements assessed by expired gas analysis both in patients with AMI (Pomes Iparraguirre et al, 1988) and in patients with severe chronic heart failure (Rubin et al, 1982).…”

Section: Discussionmentioning

confidence: 99%

Interrelationship between oxygen‐related variables in patients with acute myocardial infarction: an interpretative review

Jorge

Tavella

Irrazabal

et al. 2010

Clin Physio Funct Imaging

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The high mortality rate of cardiogenic shock in acute myocardial infarction (AMI) implies that debate over the correct haemodynamic management is still unresolved. The purpose of this review is to re-evaluate the reciprocal relationships between oxygen-related variables and response to treatment in a large number of patients with AMI. A MEDLINE search of reports published between 1970 and 2008 was performed. Twelve clinical reports including 453 patients with AMI and 989 sets of oxygen delivery and oxygen consumption expressed in ml min⁻¹ m⁻² and oxygen extraction ratio were selected. While processing this data, we found an early down-regulation in oxygen demand linked to a decrease in oxygen supply. This mechanism is also supported in some studies by a critically low oxygen uptake that was not associated with lactic acidosis.

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“…This may be due to measurement variance at several stages. These include accuracy and stability of the Deltatrac metabolic monitor, errors and assumptions in the calculation of arterial and mixed venous oxygen content 28 , and the known variation in thermodilution measurement of cardiac output 29,30 . VO2F also precludes the pulmonary component of VO2, which may be significantly early after CPB, as it is in patients with pneumonia 31 .…”

Section: Discussionmentioning

confidence: 99%

Association between Oxygen Delivery and Consumption in Patients Undergoing Cardiac Surgery. is There Supply Dependence?

Myles

McRae

Ryder

et al. 1996

Anaesth Intensive Care

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We studied the relationship between oxygen delivery (DO2) and consumption (VO2) in twenty patients undergoing cardiac surgery, in order to determine if VO2 was dependent on DO2 (pathological oxygen supply dependence). We measured VO2 from expired gas analysis (VO2G) and compared this to that calculated using the reverse Fick method (VO2F). Both VO2G and VO2F increased after cardiopulmonary bypass (P<0.001), without change in DO2 (i.e. oxygen extraction ratio increased). There was a significant relationship between changes in DO2 and VO2F, both before bypass (r=0.74, P < 0.001) and after bypass (r=0.69, P < 0.001), while changes in DO2 and VO2G had no such relationship (pre-bypass: r=0.38, P=0.094; post-bypass: r=0.10, P=0.68). There was poor agreement between VO2F and VO2G perioperatively. We could not demonstrate supply dependence in elective cardiac surgical patients.

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Comparison between measured and fick-derived values of hemodynamic and oxymetric variables in patients with acute myocardial infarction

Cited by 16 publications

References 15 publications

The role of exercise testing in predicting successful ambulation with a lower extremity prosthesis: a systematic literature review and clinical practice guideline

The role of exercise testing in predicting successful ambulation with a lower extremity prosthesis: a systematic literature review and clinical practice guideline

Interrelationship between oxygen‐related variables in patients with acute myocardial infarction: an interpretative review

Association between Oxygen Delivery and Consumption in Patients Undergoing Cardiac Surgery. is There Supply Dependence?

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