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    Feasibility of Using Near Infrared Spectroscopy in Determining VO<sub>2</sub> for Preoperative Risk Assessment

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    Authors
    Marengi, Nathan
    Faculty Advisor
    Soller, Babs R.
    UMass Chan Affiliations
    Department of Anesthesiology
    Document Type
    Poster
    Publication Date
    2008-05-01
    Keywords
    preoperative risk assessment
    VO2
    Spectroscopy
    Near-Infrared
    Exercise Test
    Oxygen Consumption
    Surgical Procedures
    Operative
    Preoperative Care
    Risk Assessment
    Analytical, Diagnostic and Therapeutic Techniques and Equipment
    Cardiology
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    Abstract
    Introduction: Cardiopulmonary exercise testing (CPX) has been used to identify elderly patients at high risk for major surgery; Older demonstrated that postoperative cardiovascular-related deaths were predicted by an anaerobic threshold (AT) < 11 ml/min/kg1. This methodology is limited by the uncomfortable and claustrophobic facemask used for standard CPX. During cycling, pulmonary oxygen consumption (VO2) is equivalent to twice muscle VO22. Our research group has developed novel methods of using near infrared spectroscopy (NIRS) to determine muscle oxygen saturation (SmO2), muscle pH and hematocrit. Hypothesis: NIRS, in combination with heart rate (HR) monitoring, may be used to determine VO2. Methods: Ten healthy subjects (5M/5F) performed CPX. Pulmonary VO2 was determined with a metabolic cart simultaneously with NIR spectra from the thigh. Muscle VO2 was calculated using the Fick equation (VO2 = SV x HR x C(a-v)O2) where stroke volume was estimated from HR. Oxygen content difference was calculated from hematocrit and SmO2 obtained with NIRS. Pulmonary and NIRS VO2 were compared by Bland-Altman analysis. AT was identified from spectrally determined pH3. Results: SV was gender specific and a mathematical equation was developed to calculate SV from HR during exercise. Our data showed that NIRS VO2 closely approximated pulmonary VO2 up to the AT. The bias between pulmonary and NIRS-measured VO2 was -0.05 L/min and the limits of agreement were -0.6 and +0.5 L/min; R2 = 0.89. Larger errors were observed for VO2> AT. Conclusion: Our results demonstrate the feasibility of using NIRS to determine VO2for preoperative risk assessment. References: 1. Older P, et al. Chest. 1999, 116:355-362. 2. Grassi et al. J Appl Physiol. 1996, 80:988-998. 3. Soller BR, et al. J Appl Physiol.2008, 104:837-844. Funded by FAER and NSBRI through NASA NCC9-58.
    DOI
    10.13028/jf2v-kz58
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49405
    Rights
    Copyright is held by the author(s), with all rights reserved.
    ae974a485f413a2113503eed53cd6c53
    10.13028/jf2v-kz58
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