Can We Better Estimate Resting Oxygen Consumption by Incorporating Arterial Blood Gases and Spirometric Determinations?

Tonelli, Adriano R.; Wang, Xiao Feng; Abbay, Anara; Zhang, Qi; Ramos, José A; McCarthy, Kevin

doi:10.4187/respcare.03555

Cited by 4 publications

(1 citation statement)

References 29 publications

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“…The chronological sequence of echocardiography, CTA, and RHC, along with the detailed process of patient selection, is presented in Supplementary Figure 2 . Body surface area (BSA) and oxygen consumption (VO 2 ) were estimated using established formulas ( 15 ). As per the Qinghai criteria, individuals were diagnosed with HAPH when mPAP was >30 mmHg ( 10 ).…”

Section: Methodsmentioning

confidence: 99%

A novel clinical prediction scoring system of high-altitude pulmonary hypertension

Zeng,

Zhakeer,

et al. 2024

Front. Cardiovasc. Med.

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BackgroundHigh-altitude pulmonary hypertension (HAPH) is a common disease in regions of high altitude where performing right heart catheterization (RHC) is challenging. The development of a diagnostic scoring system is crucial for effective disease screening.MethodsA total of 148 individuals were included in a retrospective analysis, and an additional 42 residents were prospectively enrolled. We conducted a multivariable analysis to identify independent predictors of HAPH. Subsequently, we devised a prediction score based on the retrospective training set to anticipate the occurrence and severity of HAPH. This scoring system was further subjected to validation in the prospective cohort, in which all participants underwent RHC.ResultsThis scoring system, referred to as the GENTH score model (Glycated hemoglobin [OR = 4.5], Echocardiography sign [OR = 9.1], New York Heart Association-functional class [OR = 12.5], Total bilirubin [OR = 3.3], and Hematocrit [OR = 3.6]), incorporated five independent risk factors and demonstrated strong predictive accuracy. In the training set, the area under the curve (AUC) values for predicting the occurrence and severity of HAPH were 0.851 and 0.832, respectively, while in the validation set, they were 0.841 and 0.893. In the validation set, GENTH score model cutoff values of ≤18 or >18 points were established for excluding or confirming HAPH, and a threshold of >30 points indicated severe HAPH.ConclusionsThe GENTH score model, combining laboratory and echocardiography indicators, represents an effective tool for distinguishing potential HAPH patients and identifying those with severe HAPH. This scoring system improves the clinical screening of HAPH diseases and offers valuable insights into disease diagnosis and management.

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Section: Methodsmentioning

confidence: 99%

A novel clinical prediction scoring system of high-altitude pulmonary hypertension

Zeng,

Zhakeer,

et al. 2024

Front. Cardiovasc. Med.

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Comparison of thermodilution and indirect Fick cardiac outputs in pulmonary hypertension

Alkhodair

Tsang

Cairns

et al. 2018

International Journal of Cardiology

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Modern gold standard of cardiac output measurement – A simplified bedside measurement of individual oxygen uptake in the cath lab

Schmücker

Burgdorf

Blohm

et al. 2022

Journal of Basic and Clinical Physiology and Pharmacology

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Objectives Cardiac output (CO) measurements employing the direct Fick principle represent the gold standard in right-sided heart catheterization (RHC). The current widespread approach in hemodynamic workup however uses the indirect Fick principle with assumed values for oxygen uptake (VO2) leading to incorrect CO values in up to 25% of patients. We have tested a contemporary breath-by-breath gas analyzer that allows precise real-time measurements of VO2 with appropriate time and effort to serve the direct Fick principle. Methods By means of a small and mobile metabolic cart assembled with widely used components of a standard spiroergometer, we performed bedside measurements of individual VO2. In 33 unselected, consecutive patients with various indications for RHC we compared CO values derived from indirect vs. direct Fick calculations. Results In 28 of the 33 patients, VO2 measurements were completed with a plausible dataset within a median of 3.2 (interquartile range 2.8–6.2) min. In nine of the 28 patients, CO values based on measured VO2 values differed by more than 20% from CO calculations based on assumed VO2 values with value deviations scattering over a broad range in both directions (maximally +52% to minimally −46%). Conclusions The bedside measurement of VO2 for gold standard CO determination is technically feasible within a few min and can thus be easily included in any RHC protocol. As modern therapy for numerus indications demand a precise upfront measurement of hemodynamics, our method might help to correctly identify patients for costly therapies.

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Can We Better Estimate Resting Oxygen Consumption by Incorporating Arterial Blood Gases and Spirometric Determinations?

Cited by 4 publications

References 29 publications

A novel clinical prediction scoring system of high-altitude pulmonary hypertension

A novel clinical prediction scoring system of high-altitude pulmonary hypertension

Comparison of thermodilution and indirect Fick cardiac outputs in pulmonary hypertension

Modern gold standard of cardiac output measurement – A simplified bedside measurement of individual oxygen uptake in the cath lab

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