Pulmonary Physiology: Pulmonary Physiology |

Preliminary Study of CPET in Patients With Central Airway Obstruction FREE TO VIEW

Que Chengli, MD; Xiaoling Li
Author and Funding Information

First Hospital, Peking University, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1116A. doi:10.1016/j.chest.2016.08.1224
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SESSION TITLE: Pulmonary Physiology

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To evaluate the exercise capacity and their breathing and cardiac reserve. And to look for the possibility of using cardiopulmonary exercise testing (CPET) as a criteria for stopping unnecessary interventional therapies.

METHODS: Patients who had been confirmed having central airway obstruction and had been treated by interventional bronchoscopy, performed symptom limited ramp cycle ergometer CPET between September 2013 and Feburary 2016. Arterial blood sample was taken at peak exercise.

RESULTS: Eight patients were recruited, including three patients with tracheal stenosis, two patients with tracheal and unilateral stenosis, and three patients with left or right main bronchial with right intermedius stenosis. Their median age was 37.5 (25-52), male to female ratio being 3:5. Mean VO2peak was 75 ml/min.(39-97%pred), with four patients’ VO2peak exceeding 84% predicted. Patients could be limited by ventilation (1/8), and flow limitation was observed in only three patients. However, seven out of eight patients had steeper HR-VO2 relationships, in which cardiac limitation was manifested by lowered oxygen pulse in three patients (one of who accompanied with flatterned VO2/WR), by much lower heart rate reserve in two. One of the patients was retested two years after repeated interventions. Although he was still limited by flow and flow-volume curve was typical of fix upper airway obstruction, his VO2peak improved from 60 to 86 ml/min. His oxygen pulse at peak exercise rose from 65bpm to 94bpm.The slope of HR verses VO2 was decreased.

CONCLUSIONS: Patients with central airway obstruction could have normal or reduced exercise capacity, which could be limited by ventilation or flow as well as circulation. Steeper heart rate -VO2 relationships were common. Interventional bronchoscopy could improve the exercise capacity with configuration of flow-volume curve unchanged or flow limitation remained during exercise.

CLINICAL IMPLICATIONS: CPET could potentially be used as a reassurance of intervention or no-more intervention for patients with central airway obstruction.

DISCLOSURE: The following authors have nothing to disclose: Que Chengli, Xiaoling Li

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