| Corrected end-tidal PCO2 accurately estimates arterial PCO2 at rest and during exercise in morbidly obese adults. | |
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MedLine Citation:
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PMID: 22878275 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT BACKGROUND: Obesity affects lung function, gas exchange and imposes mechanical ventilatory limitations during exercise that could disrupt the predictability of arterial PCO2 (PaCO2) from end-tidal PCO2 (PETCO2), an important clinical tool for assessing gas exchange efficiency during exercise testing. PaCO2 has been estimated during exercise with good accuracy in normal-weight individuals by using a correction equation developed by Jones et al. (PJCO2=5.5+0.9*PETCO2-2.1*tidal volume). The purpose of this project was to determine the accuracy of PaCO2 estimations from PETCO2 and PJCO2 values at rest, submaximal, and peak exercise in morbidly obese adults. METHODS: PaCO2 and PETCO2 values from 37 obese adults (22 women, 15 men, 39±9yrs, 49±7BMI, mean±SD) were evaluated. Subjects underwent ramped cardiopulmonary exercise testing to volitional exhaustion. PETCO2 was determined from expired gases simultaneously with temperature corrected arterial blood gases (radial arterial catheter) at rest, every minute during exercise, and peak exercise. Data were analyzed using paired t-tests. RESULTS: PETCO2 was not significantly different from PaCO2 at rest (PETCO2=37±3mmHg vs PaCO2=38±3mmHg, p=0.14). However, during exercise PETCO2 was significantly higher than PaCO2 (submax: 42±4 vs 40±3, p<0.001; peak: 40±4 vs 37±4, p<0.001, respectively). Jones' equation successfully corrected PETCO2, such that PJCO2 was not significantly different from PaCO2 (submax: PJCO2=40±3, p=0.650; peak: 37±4, p=0.065). CONCLUSION: PJCO2 provides a better estimate of arterial PaCO2 than PETCO2 during submaximal and at peak exercise, while at rest both yield reasonable estimates in morbidly obese individuals. Clinicians and physiologists can obtain accurate estimations of PaCO2 in morbidly obese individuals by using PJCO2.1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center, Dallas, TX.2Human Physiology Laboratory, Marywood University, Scranton, PA,3The Commonwealth Medical College, Scranton, PA.aPrevious institution: McGill University Health Center, Montreal, Quebec, CanadaCorresponding Author: T.G. Babb, Ph.D. , Institute for Exercise and Environmental Medicine, 7232 Greenville Ave., Ste 435, Dallas, Texas 75231, E-mail TonyBabb@TexasHealth.org. |
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Authors:
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Vipa Bernhardt; Santiago Lorenzo; Tony G Babb; Gerald S Zavorsky |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-8-1 |
Journal Detail:
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Title: Chest Volume: - ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-8-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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