心肺运动试验ppt课件_1.pptVIP

* Poor prognosis of cancer treated nonoperatively Therefore, goal is to avoid unnecessarily excluding patients from potentially curative surgery Clinical practice guidelines * Orthopedic, infection, cataract * Orthopedic impairment compromises exercise performance * * Peak vo2 vs maximally achievable vo2 max * Why use a bike ergometer 1. Accurate measurement of POWER. 2. Ramping protocols allow for assessment of physiologic function across all work levels. Staged protocols only assess partial physiologic function. 3. Independent of patient’s weight (Treadmill results are influenced by weight). 4. Less danger of fall and injury to patient. 5. Easier to take accurate B/P at high work rates (Patient arm is steady and there is far less noise - no treadmill motor). 6. Patient can stop at anytime. 7. Holding handle bars does not effect test (Holding treadmill handrails can significantly effect results). 8. Fits into smaller space and is portable. 9. Patients with knee or hip problems tend to perform better and report being more comfortable on the bike. 10. Bike ramp protocols are designed to last 6-10 minutes, resulting in less fatigue (yet peak work is maximized). 11. HR, Work, and VO2 (Cardiac Output) are linearly related. Bike ramp protocols produce linear increases in Work, thereby mimicking the expected physiologic response in health and disease. 12. Determination of the Anaerobic Threshold (AT) by the most popular methods (V-slope and VE/VO2 nadir) were developed and proven through the use of bike ramp protocols. To use another method means to lose AT detection accuracy. 13. Bike ramp protocols are used by many of the leading clinical and research cardiopulmonary exercise testing labs (UCLA, Duke, Mayo, Stanford, Bowman-Gray, Johns Hopkins, UAB, Temple to name a few). Recently, treadmills capable of performing ramp protocols have been developed. Carbonic acid * MV is actually VE * Incremental vs Ramp Exercise Test Protocol