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Non-Invasive Cardiac Output Measurement Using Inert Gas Rebreathing Method during Cardiopulmonary Exercise Testing-A
Agnieszka Chwiedź1,2, Łukasz Minarowski2, Robert M Mróz2
1I Department of General and Endocrine Surgery, Medical University of Bialystok, 15-276 Bialystok, Poland.
Insights
This systematic review addresses the lack of guidelines for inert gas rebreathing (IGR) during cardiopulmonary exercise testing (CPET). It proposes standardized reporting for non-invasive cardiac output measurement using IGR in clinical practice.
Area of Science:
- Cardiopulmonary Exercise Testing (CPET)
- Non-invasive Hemodynamics
- Physiological Measurement Techniques
Background:
- Inert gas rebreathing (IGR) offers non-invasive cardiac output (CO) measurement comparable to other methods.
- Current guidelines and standards for IGR during CPET are lacking for both healthy and diseased populations.
- Assessing CO non-invasively during CPET requires standardized protocols.
Purpose of the Study:
- To systematically review the application of IGR for non-invasive CO assessment during CPET.
- To propose a standardized CPET report incorporating IGR-derived CO.
- To establish guidelines for IGR use in CPET.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Comprehensive literature search across major scientific databases (PubMed, Web of Science, Scopus, Cochrane).
- Inclusion of 47 studies meeting predefined criteria from an initial search of 261 articles.
Main Results:
- Detailed description of IGR protocols, indications, and technical aspects for CPET.
- Identification of existing gaps in literature regarding standardized CPET and IGR methods.
- Critical analysis of the strengths and limitations of included studies.
Conclusions:
- The review provides a framework for standardized reporting of IGR-based CO during CPET.
- Highlights the necessity for standardized approaches in CPET to improve data reliability.
- Recommends a combined CPET-IGR report for enhanced clinical application and future research.
Background:
The use of inert gas rebreathing for the non-invasive cardiac output measurement has produced measurements comparable to those obtained by various other methods. However, there are no guidelines for the inert gas rebreathing method during a cardiopulmonary exercise test (CPET). In addition, there is also a lack of specific standards for assessing the non-invasive measurement of cardiac output during CPET, both for healthy patients and those suffering from diseases and conditions.
Aim:
This systematic review aims to describe the use of IGR for a non-invasive assessment of cardiac output during cardiopulmonary exercise testing and, based on the information extracted, to identify a proposed CPET report that includes an assessment of the cardiac output using the IGR method.
Methods:
This systematic review was conducted by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) guidelines. PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from inception until 29 December 2022. The primary search returned 261 articles, of which 47 studies met the inclusion criteria for this review.
Results And Conclusions:
This systematic review provides a comprehensive description of protocols, indications, technical details, and proposed reporting standards for a non-invasive cardiac output assessment using IGR during CPET. It highlights the need for standardized approaches to CPET and identifies gaps in the literature. The review critically analyzes the strengths and limitations of the studies included and offers recommendations for future research by proposing a combined report from CPET-IGR along with its clinical application.
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