During pulmonary rehabilitation, adequate intensity of exercise is needed. Different parameters may be used to determine if the patient is adequately challenged. We describe the use of a novel parameter pleth variability index (PVI) derived from the pulse oximetry wave form in patients with chronic lung disease undergoing pulmonary rehabilitation.
In patients undergoing pulmonary rehabilitation exercise, programs were individualized by having a one on one monitoring by a respiratory therapist. During this time, patients were routinely also monitored by pulse co-oximetry using a Radical-7 pulse co-oximeter capable of analyzing the photoplethysmographic wave form to derive a pleth variability index. PVI, before and after, along with heart rate (HR) and perfusion index (PI), were measured and data was analyzed with paired t-test.
PVI was significantly higher after adequate exercise than before and was similar to increase in HR. PVI before was 27.33 and after was 32.04 with p = 0.006. HR before was 77.37 and after was 85.67 with p = 6.42 E-10. PI was not significantly different. PI before was 2.18 and after was 2.32 with p = 0.23.
In patients with obstructive lung disease, PVI may be a useful parameter to determine adequacy of exercise in a pulmonary rehabilitation program. This may be useful in setting goals for appropriate level of exercise in these programs.
Further testing including correlation with metabolic parameters should be done in the future.
Alicia Redford, Other Radical-7 Pulse Co-oximeter was used in this study and was loaned to us by Masimo Corporation.; No Product/Research Disclosure Information