cardio pulmonary exercise testing Flashcards by jasmine mander

whats CPET stand for

cardiopulmonary exercise testing

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whats CPET

global assessment of exercise response in pulmonary, vardivalsult , nearo and skeletal systems

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indicated for CPET

determine causes of dyspnea, chest pain, exercise inteolerance

exercise prescription (training intensities)

evaluate functional impairment

evaluate effectiveness of therapy

determine disease severity/ prognosis

pre op eval

assessment of disability for workers compensation

can occupation demands be safely met

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T?F resting measurements always support physiological capacity

false, not always

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components of effective CPEt protocol

large mm exercises

measure pulmonary gas exchange from rest to peak

fixed increments in work rate (magnitude and duration) to peak

6-20 mins

measure symptom intensity

post exercise questioning

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recommended CPET exercise machines

bikes treadmill , arm ergomerty if needed, sport specific

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Bike vs treadmille
vo2 max
safety
leg fatigue
quantifying work rate
blood gas measure 
blood pressure measure
noise artificant
weight bearing

vo2 max - lower 
safety - safer
leg fatigue - more
quantifying work rate: yes
blood gas measure: easy
blood pressure measure: easy
noise artificant: less
weight bearing: less

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how to determine work rate increase

jones approach

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jones approach

standardized increments (10 watts in diseased, 25 in norm)

1-2 min stages
total test aimed 10-20 min

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symptoms to measure

breathing discomfort
mm fatigue
chest / mm pain

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most common reason for stopping exercise

dyspnea

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Dyspnea in COPD Grades

1 - can't breath when exerting
2 - breathless when hurrying / hil
3 - have to go slower than most
4- need to stop to breath after 100yds
5- too breathless to leave home

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reasons for stopping exercise example questions

dynpnea
leg fatigue
combination

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measurements during CPET

external work
metabolic gas exchange
cardiovascular
ventilatory
pulmonary gas ex
symptoms

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how to measure external work

work rate

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measuring metabolic gas exchange

v02
RER
Lactate

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measuring cardiovascular

HR, ECG, BP, 02 pulse

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measuring ventilatory

Ve (minute ventilation)

tidal volume

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Pulmonary Gas exchange measurement

Spo02

Sa02

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symptoms that you are measuring

dyspnea
fatigue
chest pain

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what values are considered evidence of reduced exercise capacity

<80-85%

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when is peak v02

clear plateau of vo2

or estimated if listed

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reduced v02 peak is problems o f?

02 transport / extraction 
pulmonary limits
neuro limits
mm limits
effort

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measure Q by

HRx stroke volume

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02 extraction determined by

02 carrying capacity, mm 02 extraction

02 carrying capacity effected by

hemoglobin concentration pa02 02 dissociation curve (affinity)

mm 02 extraction effected by

cap density mitochondrial density tissue perfusion

fick equation

Q x 02 extraction

inc in v02 does what to Q and CavDo2

increase

anything that dec Q or Cavd02 does what to v02

dec

T/f dec in Q can be compensated by Cav?

yes, maintains v02 then

HRR =

predicted HR max - HR max

if patient reached predicted HR max ?

max effort used | cardio might be exercise limitation

HR max normal

>90% predicted

HRR normal

<15bpm

when does Sv plate

near end of exercise

Sv determined by

pre load contractibty after load

how can Sv b estimated

02 pulse

whats 02 pulse

among of 02 extracted per heart beat

calc 02 pulse

Vo2 / HR

02 pulse inc, what happen Sv cavDo2

inc

flat 02 means ? Sv cavd02

dec or abdonral

T/f 02 extraation abnormalities are common

is SBp does not incase or decrease during exercise?

cardio limitation or abnormality of BP

anaerobic threshold

reflect onset of lactic during exercise upper limit of exercise % of predicted v02 max

RER stands for

respiratory exchange ratio

cal RER

VCo2/ V02

RER is

estimated % contribution of CHO or fat to energy

RER >1.1 means

they gave a good effort

when does tidal volume plateau

at 60-70% of vital capacity

incase in VE after Vt plateaus caused by

breathing frequency

ventilitaroy reserve

relationship b/w peak exercise VE and maximal voluntary max air inhaled exhaled 1 min

Vemax/ MVV norm

<80-85%

MVV - VE max normal

>11 L/min

normal Vd/Vt

.3-4

Ve/Vco2 normal

<32-34 | <36-50 at peak exercise

Vo2 / cycle work rate normal

>80-85% predicted

AT or T vent threshold normal

> 40% of predicted v02 max

HR norm

>90% age predicted

HRR normal

<15 beat/mmin

02 pulse normal

>80% predicted

ventilitaroy reserve normal

>11 l/min or <80-85 MVV

breathing frequency norm

<60 breaths/min

Ve/Vco2 ratio norm

<32-34, or <36-40

Vd/Vt normal

<0.28

Sa02 normal

> 95% or <4 of baseine

vd/vt during exercise

dec

vd/vt inc what happens gas exchange

dec

ve/vc02 is what

vent efficiency

ve/vco2 during exercise

dec early , increase near end

why ve/vco2 increase at end

vent compensation for metabolic acidosis