Rao Rohit P, Danduran Michael J, Loomba Rohit S, Dixon Jennifer E, Hoffman George M
Sections of Cardiology and Critical Care, Phoenix Children's Hospital, Phoenix, AZ, USA.
Pediatr Cardiol. 2012 Jun;33(5):791-6. doi: 10.1007/s00246-012-0217-8. Epub 2012 Feb 19.
Cardiopulmonary exercise testing (CPET) provides assessment of the integrative responses involving the pulmonary, cardiovascular, and skeletal muscle systems. Application of exercise testing remains limited to children who are able to understand and cooperate with the exercise protocol. Near-infrared spectroscopy (NIRS) provides a noninvasive, continuous method to monitor regional tissue oxygenation (rSO2). Our specific aim was to predict anaerobic threshold (AT) during CPET noninvasively using two-site NIRS monitoring. Achievement of a practical noninvasive technology for estimating AT will increase the compatibility of CPET. Patients without structural or acquired heart disease were eligible for inclusion if they were ordered to undergo CPET by a cardiologist. Data from 51 subjects was analyzed. The ventilatory anaerobic threshold (VAT) was computed on [Formula: see text] and respiratory quotient post hoc using the standard V-slope method. The inflection points of the regional rSO2 time-series were identified as the noninvasive regional NIRS AT for each of the two monitored regions (cerebral and kidney). AT calculation made using an average of kidney and brain NIRS matched the calculation made by VAT for the same patient. Two-site NIRS monitoring of visceral organs is a predictor of AT.
心肺运动试验(CPET)可评估涉及肺、心血管和骨骼肌系统的综合反应。运动试验的应用仍局限于能够理解并配合运动方案的儿童。近红外光谱(NIRS)提供了一种无创、连续的方法来监测局部组织氧合(rSO2)。我们的具体目标是使用双部位NIRS监测无创预测CPET期间的无氧阈(AT)。实现一种实用的无创技术来估计AT将提高CPET的适用性。无结构性或后天性心脏病的患者,如果心脏病专家要求其接受CPET,则符合纳入标准。对51名受试者的数据进行了分析。使用标准V斜率法在[公式:见正文]上计算通气无氧阈(VAT),并在事后计算呼吸商。将两个监测区域(脑和肾)各自的局部rSO2时间序列的拐点确定为无创局部NIRS AT。使用肾和脑NIRS的平均值进行的AT计算与同一患者的VAT计算结果相符。对内脏器官进行双部位NIRS监测是AT的一个预测指标。