Abstract

Spiroergometric measurements of persons who require oxygen insufflation due to illness can be performed under conditions of increased inspiratory oxygen concentration (FIO2). This increase in FIO2, however, often leads to errors in the calculation of oxygen consumption (). These inconsistencies are due to the application of the Haldane Transformation (HT), an otherwise indispensable correction factor in the calculation of that becomes inaccurate at higher FIO2 concentrations. A possible solution to this problem could be the use of the ‘Eschenbacher transformation’ (ET) as an alternative correction factor. This study examines the concentration of FIO2 at which the HT and the ET are valid, providing plausible data of oxygen consumption corresponding to the wattage achieved during cycle ergometry. Ten healthy volunteers underwent spiroergometric testing under standard conditions (FIO2 = 20.9%), as well as at FIO2 = 40% and 80%. When compared with the predicted values of , as calculated according to Wasserman et al. (2012), the data obtained show that both the HT and ET are valid under normal conditions and at an increased FIO2 of 40%. At FIO2 concentrations of 80%, however, the values provided by the HT begin to lose plausibility, whereas the ET continues to provide credible results. We conclude that the use of the ET in place of the HT in spiroergometric measurements with increased FIO2 allows a reliable evaluation of stress tests in patients requiring high doses of supplemental oxygen.

Highlights

  • For patients who are dependent on a continuous supply of supplementary oxygen, it is potentially dangerous to perform classical spiroergometry without oxygen insufflation

  • This company provided the spiroergometry devices, the used material, and a small compensation for each of the 10 participants of the study. (CareFusion changed to Vyaire medical and is since 2015 part of BD an international medical technology company.) CareFusion as owner of the used CPETdevice “Vyntus CPX” did not have any influence on the content and realisation of this study

  • The results provided by the Eschenbacher transformation’ (ET) and the Haldane transformation (HT) deviated from the expected V_O2 values by 5.1 ± 5.9% and 41.9 ± 3.2%, respectively (Table 3)

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Summary

Introduction

For patients who are dependent on a continuous supply of supplementary oxygen, it is potentially dangerous to perform classical spiroergometry without oxygen insufflation. In order to obtain usable data, testing under conditions of increased inspiratory oxygen concentration (FIO2) is necessary. With this method, patients inhale oxygen-enriched air from a gas reservoir. D. student position at the University Medical Center Hamburg-Eppendorf, SL worked as a Product Manager for CareFusion, Hochberg, Germany. This company provided the spiroergometry devices, the used material, and a small compensation for each of the 10 participants of the study. CareFusion wanted to support SL with his doctoral thesis by providing the CPET-device without direct commercial purpose This does not alter our adherence to PLOS ONE policies on sharing data and materials. RH, AK, VH and AMP declare, to have no conflicts of interest regarding this study

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