Effect of a viral filter on cardiopulmonary exercise testing

Marques, Marta Sá; Fonseca, Ana; Lima, Ricardo; Ladeira, Inês; Gomes, Joana; Guimarães, Miguel

doi:10.1016/j.pulmoe.2021.07.006

Cited by 7 publications

(5 citation statements)

References 5 publications

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“…A PhD thesis of 2012 [89] outlined a trend towards significance of the increase in ventilation at peak exercise in the presence of a filter but this aspect needs to be verified and validated in further larger studies involving patients and not only healthy volunteers. More recently researchers have confirmed the deleterious effects of using filters during CPET and the impact on measurements and interpretation of results [90].…”

Section: I) Cardiopulmonary Exercise Tests (Cpet)mentioning

confidence: 94%

International consensus on lung function testing during the COVID-19 pandemic and beyond

et al. 2021

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COVID-19 has negatively affected the delivery of respiratory diagnostic services across the world due to the potential risk of disease transmission during lung function testing. Community prevalence, reoccurrence of COVID-19 surges, and the emergence of different variants of the SARS-CoV-2 virus have impeded attempts to restore services. Finding consensus on how to deliver safe lung function services for both patients attending and for staff performing the tests are of paramount importance.This international statement presents the consensus opinion of 23 experts in the field of lung function and respiratory physiology balanced with evidence from the reviewed literature. It describes a robust roadmap for restoration and continuity of lung function testing services during the COVID-19 pandemic and beyond.Important strategies presented in this consensus statement relate to the patient journey when attending for lung function tests. We discuss appointment preparation, operational and environmental issues, testing room requirements including mitigation strategies for transmission risk, requirement for improved ventilation, maintaining physical distance, and use of personal protection equipment. We also provide consensus opinion on precautions relating to specific tests, filters, management of special patient groups, and alternative options to testing in hospitals.The pandemic has highlighted how vulnerable lung function services are and forces us to re-think how long term mitigation strategies can protect our services during this and any possible future pandemic. This statement aspires to address the safety concerns that exist and provide strategies to make lung function tests and the testing environment safer when tests are required.

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Section: I) Cardiopulmonary Exercise Tests (Cpet)mentioning

confidence: 94%

International consensus on lung function testing during the COVID-19 pandemic and beyond

et al. 2021

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“…They posited that this could increase expiratory resistance thereby reducing maximal exercise capacity and increasing dyspnoea. The current evidence is limited to studies of very low numbers, with two studies showing that filters placed distal to the sampling line alter CPET parameters, 91,92 whereas one study ( n = 2) using an inline filter proximal to the sampling line showed no effect on CPET parameters 93 . None of the studies included patients with respiratory or cardiac disease.…”

Section: Resultsmentioning

confidence: 97%

Pulmonary function testing during SARS‐CoV‐2: An ANZSRS/TSANZ position statement

Borg

Osadnik

Adam³

et al. 2022

Respirology

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The Thoracic Society of Australia and New Zealand (TSANZ) and the Australian and New Zealand Society of Respiratory Science (ANZSRS) commissioned a joint position paper on pulmonary function testing during coronavirus disease 2019 (COVID‐19) in July 2021. A working group was formed via an expression of interest to members of both organizations and commenced work in September 2021. A rapid review of the literature was undertaken, with a ‘best evidence synthesis’ approach taken to answer the research questions formed. This allowed the working group to accept findings of prior relevant reviews or societal document where appropriate. The advice provided is for providers of pulmonary function tests across all settings. The advice is intended to supplement local infection prevention and state, territory or national directives. The working group's key messages reflect a precautionary approach to protect the safety of both healthcare workers (HCWs) and patients in a rapidly changing environment. The decision on strategies employed may vary depending on local transmission and practice environment. The advice is likely to require review as evidence grows and the COVID‐19 pandemic evolves. While this position statement was contextualized specifically to the COVID‐19 pandemic, the working group strongly advocates that any changes to clinical/laboratory practice, made in the interest of optimizing the safety and well‐being of HCWs and patients involved in pulmonary function testing, are carefully considered in light of their potential for ongoing use to reduce transmission of other droplet and/or aerosol borne diseases.

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“…The sample size determination was based on previous literature [1]; [2]; [3], which enrolled 10, 12, and 2 participants for the impact of filter on CPET. The sample size of 11 in our study may appear small.…”

Section: Viral Filters Could Affect Cpet and Spirometry Results Throu...mentioning

confidence: 99%

“…However, three articles reported different findings. With filters, Marques et al observed a significant increase in oxygen consumption (V ̇O2 , 82.0% vs. 90.5%, p = 0.006) [1]; Stacey et al noted increase in V ̇O2 (+5.6 ml/min/kg, p < 0.001) and minute ventilation (V ̇E, +10.2 L/min, p < 0.001) [2]; Bhat et al reported opposite changes in V ̇O2 in two subjects [3]. These studies differed in filter brands and placement.…”

mentioning

confidence: 98%