A Practical Guide to the Interpretation of Cardiopulmonary Exercise Tests

by William Kinnear, James H. Hull

Overview

Maximum oxygen uptake during exercise is one of the best predictors of operative mortality and of prognosis in chronic cardiac or respiratory disease. Cardiopulmonary exercise tests (CPET) are therefore an increasingly common component of pre-operative assessment and the management of patients with chronic cardiopulmonary problems. Part of the Oxford Respiratory Medicine Library (ORML) series, A Practical Guide to the Interpretation of Cardiopulmonary Exercise Tests, Second Edition provides readers with a practical, concise, and accessible approach to all aspects of cardiopulmonary exercise tests (CPET). CPET is often perceived as being incredibly complex to evaluate so this book breaks down interpretation to simple steps, allowing readers to rapidly understand the key points underpinning the application and interpretation of CPET. The text is focused and with the use of a substantial number of figures, learning points, and self-test questions helps readers to build confidence in undertaking and interpreting CPET. The second edition has been extended and extensively revised in line with the latest international guidelines and evidence, and includes 16 fully updated chapters, 4 new chapters, and a new section of worked examples has been added.

Product Details

ISBN-13:	9780192571359
Publisher:	OUP Oxford
Publication date:	01/20/2021
Series:	Oxford Respiratory Medicine Library
Sold by:	Barnes & Noble
Format:	eBook
Pages:	224
File size:	7 MB

About the Author

William Kinnear is a Consultant Respiratory Physician at Circle Nottingham, Nottingham NHS Treatment Centre, Queen's Medical Centre Campus, Nottingham, UK and a Senior Lecturer in Sport Science at Nottingham Trent University. He studied at University College London and Westminster Hospital Medical School. He trained at the Brompton Hospital in London, Papworth Hospital and Addenbrooke's Hospital in Cambridge before moving to Nottingham. A Wellcome scholarship enabled him to spend a year at Erasmus Hospital in Brussels, developing his interest in respiratory muscle physiology. He worked as a consultant respiratory physician at the Queens Medical Centre in Nottingham for 25 years, setting up the regional non-invasive ventilation and sleep services. He introduced cardio-pulmonary exercise testing in the lung function laboratory and has published widely in the field of respiratory physiology. James H. Hull, PhD, FRCP, FACSM is a Consultant Respiratory Physician at the Royal Brompton Hospital, London, UK and Hon. Associate Professor at the Institute of Sport, Exercise and Health (ISEH), UCL, London. His interest in exercise testing started with an undergraduate degree in exercise physiology at St George's Hospital Medical School with Professor Brian Whipp. He later completed a PhD in vascular physiology and was then awarded a National Institute for Health Research Clinical Lectureship, during which he spent time at UCLA, California developing expertise in clinical exercise testing. He currently personally supervises over 250 CPET tests per year, as lead for the clinical unexplained breathlessness service at the Royal Brompton.

Table of Contents

Abbreviations xi

Section 1 Introduction 1

1 Why do a cardiopulmonary exercise test? 3

2 Pre-test assessment 7

3 Supervising a CPET 13

4 How to do a CPET 13

Section 2 Key cardiopulmonary exercise test parameters 33

5 Oxygen uptake 35

6 Heart rate 44

7 Oxygen pulse 51

8 Ventilation 56

9 Carbon dioxide output 63

10 Respiratory exchange ratio 72

11 Ventilatory equivalents 77

12 Anaerobic threshold 86

13 Respiratory compensation point 93

14 Oxygen saturation 97

15 Additional respiratory measurements 102

Section 3 Using CPET data 107

16 Presentation of results 109

17 Interpretative strategy 115

18 Clinical scenarios 123

19 Preoperative cardiopulmonary exercise testing 133

20 Exercise prescription 138

Appendices

Learning point questions 145

List of learning points 147

Practical tip questions 151

List of practical tips 153

Example exam questions 159

Glossary 211

Bibliography 213

Index 215

Editorial Reviews

"This book breaks the interpretation down into simple steps which aids understanding and application. For anyone interested in performing and interpreting cardiopulmonary exercise tests this book aims to provide all the required information, and achieves this goal well." — Dr Katie Marino, BJSM

From the Publisher