Sledované parametre zo spiroergometrického vyšetrenia (vedecké)

Sledované parametre zo spiroergometrického vyšetrenia (surové)

Skratky a pojmy pre spoznanie dôležitých spiroergometrických ukazovateľov v pôvodnom anglickom jazyku. Uvedené parametre generuje spiroergometrický prístroj (napríklad Ganshorn PowerCube Ergo), na základe ktorého v aplikácii MET/FLEX vyhodnocujeme metabolickú realitu jedinca. S týmito parametrami sa stretnete aj v odbornej literatúre a vedeckých prácach, alebo pri lekárskej intervencii za pomoci týchto prístrojov [i], [ii]:

• AT (anaerobic threshold): Exercise Vo2 that marks the transition between no change or little change in arterial lactate concentration and the sustained increase in concentration of lactate (also known as the lactate threshold). Postulated by some authors to be the Vo2 above which anaerobic energy production substantially supplements aerobic energy production 
• ATPS (ambient temperature, pressure, saturated with water): Volume of gas at ambient (e.g., room) temperature and pressure, and saturated with water vapor at this temperature
• B by B (Breath by breath): Value of a particular physiologic variable measured over one breath (entire respiratory cycle) and extrapolated to 1 minute (e.g., O2 uptake for a single) breath, expressed as liters per minute)
• BTPS (body temperature, pressure, saturated with water): Volume of gas at body temperature (37 C), ambient pressure, and saturated with water vapor at the subject’s body temperature 
• CaO2 (oxygen content in arterial blood): Volume of O2 (in milliliters) in a given volume of arterial blood (deciliters or liters) 
• CvO2 (oxygen content in mixed venous blood): Volume of O2 (in milliliters) in a given volume of mixed venous blood (deciliters or liters) 
• C(a–v)O2 (arterial–mixed venous difference for oxygen content): Difference in O2 content between arterial and mixed venous blood; expressed in milliliters of O2 per deciliter or liter of blood 
• CW (constant work rate test): Exercise test in which a constant work rate (or power output) is imposed on the subject (see SS [Steady state]) 
• EELV (end-expiratory lung volume): Lung volume at the end of an exercise tidal volume. Dynamic FRC resulting from recruitment of expiratory and inspiratory muscles and timing. 
• FEV1 (forced expiratory volume in 1 second): Volume of gas exhaled from the lungs during the first second of a forced expiratory maneuver (FVC), expressed in liters (btps) 
• fr (respiratory frequency): Number of breathing cycles per minute 
• HR (heart rate): Number of heart beats per minute
• HRR (heart rate reserve): Difference between the highest heart rate attained during a maximal exercise test and the maximal value predicted for that subject. Expressed in units of beats per minute
• IET (incremental exercise test): Exercise test designed to provide gradational stress to the subject, typically to the limit of tolerance. The work rate is increased progressively in uniform increments, usually every minute (or 2 or 3 minutes), or continuously (e.g., ramp pattern increment)
• LT (lactate threshold): See AT (Anaerobic threshold)
• MET (metabolic equivalent): Unit used to estimate the metabolic cost of physical activity, in terms of multiples of the subject’s resting metabolic rate. One metabolic equivalent is, by convention, 3.5 ml of O2 uptake per minute per kilogram body weight, and theoretically approximates the resting meta- bolic rate 
• Mixing chamber: Device that provides a continuous representation of the mixed expired concentration of the respired gas. This is accomplished by means of a chamber that has a series of baffles so that the dead space and alveolar components of the expirate are completely mixed before the sampling site. It is essential, when using such a device under non-steady state conditions, to correct for the transport-plus-mixing delay in determining the gas concentration 
• MVV (maximal voluntary ventilation): Maximal volume of air that can be breathed per minute by a subject. This is conventionally measured from a maximal volitional breathing effort for a short period of time (e.g., 12 seconds) over which the exhaled volume is summed and expressed in units of liters per minute (btps) 
• O2 debt (oxygen debt): Amount of O2 utilized, in the recovery phase of exercise, that is in excess of that required to maintain the recovery condition (usually rest or some low recovery work rate) in the steady state. It is expressed in units of milliliters or liters (stpd) 
• O2 deficit (oxygen deficit): Difference between the product of steady state O2 uptake and the work duration and the total O2 actually taken up by the body during the exercise. It is expressed in units of milliliters or liters (stpd) 
• O2 pulse (oxygen pulse): Oxygen uptake divided by the heart rate. Corresponds to the O2 uptake per heart beat. It is numerically equal to the product of the stroke volume and arterial – mixed venous O2 difference [C(a–v)O2] and is expressed in units of milliliters of O2 per beat. Is used as an estimator of stroke volume when it is assumed that C(a–v)O2 is maximal and normal. Accordingly, inferences about stroke volume are highly dependent on these assumptions 
• P(A–a)O2 (alveolar–arterial difference for PO2): Difference between “ideal” alveolar Po2 and arterial Po2. Expressed in units of millimeters of mercury (or kilopascals) 
• PETCO2 (end-tidal PCO2): Pco2 of respired gas, determined at the end of an exhalation. This is commonly the highest Pco2 measured during the alveolar phase of the exhalation. It is expressed in units of millimeters of mercury (or kilopascals). 
• PETO2 (end-tidal PO2): Po2 of respired gas, determined at the end of an exhalation. This is typically the lowest Po2 during the alveolar portion of the exhalation. It is expressed in units of millimeters of mercury (or kilopascals). 
• (Power): Power is work per unit of time. Consequently, the term is synonymous with “work rate.” It is measured in watts (i.e., joules per second) or kilopondmeters per minute. One watt is equivalent to 6.12 kpm/minute 
• Q (cardiac output): Volume of blood pumped from the heart each minute and expressed in units of liters per minute. It is the product of stroke volume and heart rate 
• RER or R (respiratory exchange ratio): Ratio of CO2 output to O2 uptake per unit of time (measured at the mouth). This ratio reflects not only tissue metabolic exchange of the gases, but also that resulting from transient changes in the body’s gas stores. For example, the gas exchange ratio exceeds the respiratory quotient as additional CO2 is evolved from the body stores durin hyperventilation; similarly, the gas exchange ratio is less than the respiratory quotient when CO2 is being retained during hypoventilation
• RQ (respiratory quotient): Ratio of the rate of CO2 production to O2 consumption. This ratio reflects the metabolic exchange of the gases in the body’s tissues and is dictated by substrate utilization 
• SaO2 (arterial oxygen saturation): Actual amount of O2 bound to hemoglobin in a given volume of arterial blood and ex- pressed as a percentage of the total capacity for O2 binding of the hemoglobin in that blood volume 
• SpO2 (arterial oxygen saturation as indicated by pulse oximetry): Noninvasive estimation of arterial hemoglobin oxygen saturation, using a device that utilizes the combined principles of spectrophotometry and pulse plethysmography. The probe (sensor) can be used on the ear lobe or fingertip 
• SS (steady state): Denotes an exercise situation in which the O2 uptake equals the O2 requirements of the tissues. Consequently the O2 uptake and other cardiopulmonary variables remain fairly constant and there is no accumulation of lactic acid in the body. This condition is usually attained during constant submaximal levels of moderate exercise or under resting conditions. It typically follows a “non-steady-state” phase in which the variable is changing toward its steady state level. The time to achieve a steady state, however, often differs for different physiologic variables 
• STPD (standard temperature, pressure, dry): Volume of gas under standard conditions of temperature (0 C) and barometric pres- sure (760 mm Hg), and humidity (partial pressure of water, 0 mm Hg) 
• V (mixed venous blood): Blood from (or in) a vascular compart- ment representative of the venous blood returning from all the organs of the body. Blood obtained from the pulmonary artery is considered to be mixed venous blood 
• VA (alveolar ventilation): Conceptually, this is the volume of inspired gas that reaches the alveoli per minute, or the volume of gas that is evolved from the alveoli per minute. In practice, it is computed as the theoretical alveolar ventilation necessary to produce the current level of arterial Pco at the current 2 level of CO2 output. It is expressed in units of milliliters per minute or liters per minute (btps)
• VC (vital capacity): Maximal volume of gas exhaled from the point of maximal inspiration, and corresponds to TLC RV. It is expressed in units of liters (btps)
• VCO2 (carbon dioxide output): Amount of CO2 exhaled from the body per unit of time, expressed in milliliters per minute or liters per minute (stpd). This can differ from CO2 production under conditions in which CO2 is going to or coming from the body’s stores. 
• CO2: production is the amount of CO2 produced by the body’s metabolic processes, expressed in units of milliliters per minute or liters per minute (stpd). In the steady state, CO2 output equals CO2 production 
• VD (physiologic dead space): Notional volume of inspired gas that does not reach a gas-exchanging unit. The physiologic dead space is therefore the sum of the anatomic dead space (see below) and the alveolar dead space (the volume of alveoli that are ventilated but unperfused and a component of those that are underperfused). It is expressed in units of milliliters or liters (btps) 
• VDanat (anatomic dead space): Notional volume of inspired gas that stays in the conducting zone of the airways (that does not reach the alveoli). It is expressed in units of milliliters or liters (btps) 
• VD/VT (ratio of physiologic dead space to tidal volume): Proportion of tidal volume that is made up of the physiologic dead space. It is a dimensionless quantity, conventionally expressed as a fraction. Used as an index of ventilation–perfusion mismatching
• VE (minute ventilation): Volume of expired air exhaled from the lungs in 1 minute. This is conventionally expressed in units of liters per minute (btps)
• VEmax (maximal exercise ventilation): Highest minute ventilation achieved during a maximal exercise test. This is usually determined by tests that tax large muscle masses, such as cycle ergometry or treadmill. It is conventionally expressed in liters per minute (btps) 
• VE/MVV (ventilatory reserve): Expresses the relationship of ventilatory demand as reflected by peak VE to ventilatory capacity. MVV is conventionally used as an index of ventilatory capacity. This ratio is expressed as (VEmax/MVV) 100. The term is synonymous with breathing reserve 
• VE/VCO2 (ventilatory equivalent for carbon dioxide): Ratio of the subject’s minute ventilation (btps) to CO2 output (stpd). It is a dimensionless quantity. This ratio indicates how many liters of air are being breathed to eliminate 1 liter of CO2. It is used as a noninvasive estimator of appropriateness of ventilation 
• VE/VO2 (ventilatory equivalent for oxygen): Ratio of the subject’s minute ventilation (btps) to O2 uptake (stpd). It is a dimensionless quantity. This ratio indicates how many liters of air are being breathed for each liter of O2 uptake 
• VO2 (oxygen uptake): Volume of O2 extracted from inspired air in a given period of time, expressed in milliliters per minute or liters per minute (stpd). This can differ from O2 consumption under conditions in which O2 is flowing into or being utilized from the body’s stores. O2 consumption is the amount of O2 utilized by the body’s metabolic processes in a given time, expressed in units of liters per minute (stpd). In the steady state, O2 uptake equals O2 consumption 
• VO2max (maximal oxygen uptake): Traditionally the highest attainable O2 uptake for a given subject. It is determined during dynamic exercise from a “plateauing” of Vo2 despite work rate continuing to increase. In the absence of a discernible plateau, the highest Vo2 actually attained on the test is more properly termed VO2peak. Both Vo2max and Vo2peak are conventionally expressed in units of milliliters per minute or liters per minute (stpd) or, corrected for body weight, as milliliters per minute per kilogram 
• VO2peak (oxygen uptake at peak exercise): Highest Vo2 achieved on a test performed to the limit of tolerance. No additional criteria are needed for its determination, such as evidence of plateauing, to justify a Vo2max. It is conventionally expressed in units of liters per minute or milliliters per minute (stpd) 
• VO2/ WR: Increase in O2 uptake in response to a simultaneous increase in work rate (see below). Under appropriate conditions, this may be used to estimate the efficiency of muscular work. It is usually expressed in units of milliliters of O2 per minute (stpd) per watt 
• V-slope method: One of several noninvasive techniques for estimating the onset of lactic acidosis during an incremental exercise test. It is based on the ability to detect excess CO2 output generated from bicarbonate buffering of lactic acid 
• VT (tidal volume): Volume of air inhaled or exhaled with each breath. Could be the volume of a particular breath or the average breath volume over a specified period of time— usually 1 minute. It is conventionally expressed in units of milliliters or liters (btps) 
• Work: Application of a force through a distance in the direction of the force, or the product of force and the distance over which it is moved. Work is expressed in units of joules (i.e., kg · m2 · second–2). Under conditions in which force is applied and no movement results (e.g., during an isometric contracion), no work is performed, despite increased metabolic energy expenditure
• Work intensity: Unlike the work rate (see below), which is an absolute physical construct and measured in units of power, work intensity reflects the relative ease or difficulty of per- forming a task. The same work rate (e.g., 50 W) could be moderate for one subject but heavy or very heavy for another 
• WR (work rate or power): Reflects the rate at which work is performed (i.e., work performed per unit of time). Work rate is usually measured in watts (i.e., joules per second) or, alterna- tively, in kilopond · meters per minute (kpm per minute); 1 W is equivalent to 6.12 kpm/minute 

• [i]. Wassermann, et. all.: Excercise Testing and Interpretation. Including Pathophysiology and Clinical Applications, (Fifth Edition) 2012.
• [ii]. Simon A, et al. Standards for the use of cardiopulmonary exercise testing for the functional evaluation of cardiac patients: a report from the Exercise Physiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Europ J Cardiol. 2009;16:249-267.

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