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Abbasi A, Ahmad K, Ferguson C, Soriano A, Calmelat R, Rossiter HB, Casaburi R, Stringer WW, Porszasz J. Lack of effect of an in-line filter on cardiopulmonary exercise testing variables in healthy subjects. Eur J Appl Physiol 2024; 124:1027-1036. [PMID: 37803179 DOI: 10.1007/s00421-023-05327-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
PURPOSE Pathogen transmission during cardio-pulmonary exercise testing (CPET) is caused by carrier aerosols generated during respiration. METHODS Ten healthy volunteers (age range: 34 ± 15; 4 females) were recruited to see if the physiological reactions to ramp-incremental CPET on a cycle ergometer were affected using an in-line filter placed between the mouthpiece and the flow sensor. The tests were in random order with or without an in-line bacterial/viral spirometer filter. The work rate aligned, time interpolated 10 s bin data were compared throughout the exercise period. RESULTS From rest to peak exercise, filter use increased only minute ventilation ([Formula: see text]E) (Δ[Formula: see text]E = 1.56 ± 0.70 L/min, P < 0.001) and tidal volume (VT) (ΔVT = 0.10 ± 0.11 L, P = 0.014). Over the entire test, the slope of the residuals for [Formula: see text]CO2 was positive (0.035 ± 0.041 (ΔL/L), P = 0.027). During a ramp-incremental CPET in healthy subjects, an in-line filter increased [Formula: see text]E and VT but not metabolic rate. CONCLUSION In conclusion, using an in-line filter is feasible, does not affect appreciably the physiological variables, and may mitigate risk of aerosol dispersion during CPET.
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Affiliation(s)
- Asghar Abbasi
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA.
| | - Khadije Ahmad
- Division of Cardiology, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Carrie Ferguson
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA
| | - April Soriano
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA
| | - Robert Calmelat
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA
| | - Harry B Rossiter
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA
| | - Richard Casaburi
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA
| | - William W Stringer
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA
| | - Janos Porszasz
- Division of Respiratory and Critical Care Physiology and Medicine, Department of Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W Carson St, CDCRC Building, Torrance, CA, 90502, USA
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Meijer R, Schep G, Regis M, Papen-Botterhuis NE, Savelberg HHCM, van Hooff M. Test-retest reliability of the FitMáx©-questionnaire in a clinical and healthy population. J Patient Rep Outcomes 2024; 8:3. [PMID: 38175456 PMCID: PMC10767039 DOI: 10.1186/s41687-023-00682-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE The FitMáx© was developed as a questionnaire-based instrument to estimate Cardiorespiratory Fitness (CRF) expressed as oxygen uptake at peak exercise (VO2peak). Test-retest reliability is a clinometric measurement property, which defines stability over time if multiple measurements are performed (i.e. reliability). The present study aimed to assess the test-retest reliability of the FitMáx©-questionnaire in different patient groups. PATIENTS AND METHODS A total of 127 cardiac, pulmonary and oncology patients and healthy subjects aged 19-84 years who completed the questionnaire twice within an average of 18 days were included for analysis. Participants were in a stable clinical situation (no acute disease or participating in a training program). To determine the test-retest reliability, the Intraclass Correlation Coefficient (ICC) and Standard Error of the Measurement (SEM) was calculated between the first (T0) and second (T1) administration of the questionnaires. RESULTS An excellent agreement was found between the FitMáx©-questionnaire scores at T0 and T1, with an ICC of 0.97 (SEM 1.91) in the total study population and an ICC ranging from 0.93 to 0.98 (SEM 1.52-2.27) in the individual patient groups. CONCLUSION The FitMáx©-questionnaire proves to be reliable and stable over time to estimate CRF of patients and healthy subjects. Trial registration NTR (Netherlands Trial Register), NL8846. Registered 25 August 2020, https://trialsearch.who.int/Trial2.aspx?TrialID=NL8846.
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Affiliation(s)
- Renske Meijer
- Department of Sports and Exercise, Máxima Medical Centre (Máxima MC), Veldhoven, The Netherlands.
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Goof Schep
- Department of Sports and Exercise, Máxima Medical Centre (Máxima MC), Veldhoven, The Netherlands
| | - Marta Regis
- Department of Mathematics and Computer Science, University of Technology, Eindhoven, The Netherlands
| | | | - Hans H C M Savelberg
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Martijn van Hooff
- Department of Sports and Exercise, Máxima Medical Centre (Máxima MC), Veldhoven, The Netherlands
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Schönffeldt-Guerrero P, Gochicoa-Rangel L, Aguirre Franco C, Arce SC, Rodríguez Flores C. ALAT 2023 Recommendations for Performing Respiratory Function Studies. Arch Bronconeumol 2023; 59:619-620. [PMID: 37210255 PMCID: PMC10165494 DOI: 10.1016/j.arbres.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/22/2023]
Affiliation(s)
| | | | | | - Santiago C Arce
- Instituto de Investigaciones Médicas A. Lanari, Universidad de Buenos Aires, Argentina
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Borg BM, Osadnik C, Adam K, Chapman DG, Farrow CE, Glavas V, Hancock K, Lanteri CJ, Morris EG, Romeo N, Schneider‐Futschik EK, Selvadurai H. Pulmonary function testing during
SARS‐CoV
‐2: An
ANZSRS
/
TSANZ
position statement. Respirology 2022; 27:688-719. [PMID: 35981737 PMCID: PMC9539179 DOI: 10.1111/resp.14340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/30/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Brigitte M. Borg
- Respiratory Medicine The Alfred Melbourne Victoria Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Christian Osadnik
- Department of Physiotherapy Monash University Frankston Victoria Australia
- Monash Lung Sleep Allergy & Immunology Monash Health Clayton Victoria Australia
| | - Keith Adam
- Sonic HealthPlus Osborne Park Western Australia Australia
| | - David G. Chapman
- Respiratory Investigation Unit, Department of Respiratory Medicine Royal North Shore Hospital St Leonards New South Wales Australia
- Airway Physiology & Imaging Group, Woolcock Institute of Medical Research The University of Sydney Glebe New South Wales Australia
- Discipline of Medical Science, School of Life Sciences, Faculty of Science University of Technology Sydney Ultimo New South Wales Australia
| | - Catherine E. Farrow
- Airway Physiology & Imaging Group, Woolcock Institute of Medical Research The University of Sydney Glebe New South Wales Australia
- Respiratory Function Laboratory, Department of Respiratory and Sleep Medicine Westmead Hospital Westmead New South Wales Australia
- Westmead Clinical School, Sydney Medical School, Faculty of Medicine and Health Sciences The University of Sydney Sydney New South Wales Australia
| | - Vanda Glavas
- Respiratory SA Kent Town South Australia Australia
| | - Kerry Hancock
- Chandlers Hill Surgery Happy Valley South Australia Australia
| | - Celia J. Lanteri
- Department of Respiratory & Sleep Medicine Austin Health Heidelberg Victoria Australia
- Institute for Breathing and Sleep Austin Health Heidelberg Victoria Australia
| | - Ewan G. Morris
- Department of Respiratory Medicine Waitematā District Health Board Auckland New Zealand
| | - Nicholas Romeo
- Department of Respiratory Medicine Northern Health Epping Victoria Australia
| | - Elena K. Schneider‐Futschik
- Cystic Fibrosis Pharmacology Laboratory, Department of Biochemistry & Pharmacology University of Melbourne Parkville Victoria Australia
- School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne Parkville Victoria Australia
| | - Hiran Selvadurai
- Department of Respiratory Medicine The Children's Hospital, Westmead, Sydney Childrens Hospital Network Sydney NSW Australia
- Discipline of Child and Adolescent Health Sydney Medical School, The University of Sydney Sydney NSW Australia
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Lands LC. Re-opening the pediatric pulmonary function laboratory during the ongoing COVID-19 pandemic. Paediatr Respir Rev 2022; 42:49-52. [PMID: 35428587 PMCID: PMC8756810 DOI: 10.1016/j.prrv.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 10/27/2022]
Abstract
The COVID-19 pandemic continues with new waves of intensification. This review provides an update based on international recommendations concerning the conduct of pulmonary function testing in a manner to limit risk to both patient and tester.
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McGowan A, Laveneziana P, Bayat S, Beydon N, Boros PW, Burgos F, Fležar M, Franczuk M, Galarza MA, Kendrick AH, Lombardi E, Makonga-Braaksma J, McCormack MC, Plantier L, Stanojevic S, Steenbruggen I, Thompson B, Coates AL, Wanger J, Cockcroft DW, Culver B, Sylvester K, De Jongh F. International consensus on lung function testing during COVID-19 pandemic and beyond. ERJ Open Res 2021; 8:00602-2021. [PMID: 35261912 PMCID: PMC8607240 DOI: 10.1183/23120541.00602-2021] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 10/31/2021] [Indexed: 11/05/2022] Open
Abstract
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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