By William Kinnear, John Blakely

ISBN-10: 0198702469

ISBN-13: 9780198702467

Greatest oxygen uptake in the course of workout is without doubt one of the most sensible predictors of operative mortality and of diagnosis in continual cardiac or respiration sickness. Cardio-pulmonary workout (CPEX) checks are accordingly an more and more universal portion of pre-operative evaluation and the administration of sufferers with continual cardiopulmonary difficulties. a part of the Oxford respiration medication Library (ORML) sequence, this pocketbook courses clinicians throughout the parameters measured in CPEX checking out if you want to comprehend the underlying body structure and may be able to interpret the consequences. medical situations, universal styles, key issues, and useful counsel all make this publication effortless to keep on with, even for these readers who've little previous wisdom of the topic.

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Extra info for A Practical Guide to the Interpretation of Cardio-Pulmonary Exercise Tests

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Lower VO2max is associated with earlier death in the general population without diagnosed major illness. VO2max is closely related to risk of death or major complication in cardiac and lung surgery and is associated to varying degrees with poor outcomes in other major surgeries. 3. Lower VO2max is associated with a poorer outcome in chronic cardiopulmonary diseases. , Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc. 2000 Jan;32():70–84.

43 44 Chapter 8 Respiratory exchange ratio Key points • The respiratory exchange ratio (RER) is the ratio of carbon dioxide output (VCO2)/oxygen uptake (VO2). 0: VCO2 rises more steeply, reflecting the production of carbon dioxide (CO2) from the buffering of lactic acid, whereas VO2—by definition—cannot increase. • Subjects with dysfunctional breathing have erratic RER traces.  What is the RER? It is time for another derived parameter: the RER is the VCO2 divided by VO2: RER = VCO2 / VO2 . 2 Why is RER measured?

3 HCO3– buffering of lactic acid Initially, the hydrogen ions (H+) from the lactic acid produced in muscle is buffered by HCO3–, producing water (H2O) and carbon dioxide (CO2): H+ + HCO3- → H2O + CO2 The water is easy to get rid of, but where does the CO2 go? It is eliminated by increasing ventilation, of course. , when carbon dioxide output (VCO2) and VO2 are both plotted against time (top right in a nine-panel format), the VCO2 crosses the VO2 graph at the AT and continues to rise as VO2 tails off towards its maximal value.

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A Practical Guide to the Interpretation of Cardio-Pulmonary Exercise Tests by William Kinnear, John Blakely

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