Cardiopulmonary Ex testing, Norms and Definitions

Question 1

What are the reasons for ceasing an exercise test/ program?

Answer 1

• > 20 mmHg decrease in SBP with an increase in workload
• > 250mmHg SBP and >115mmHg DBP
• PaO2 less than 55 mmHg (drop in 20 mmHg in PaO2)
• Failure of HR or SBP to rise or fall with increasing effort
• maximal SOB
• cardiac ischemia or arrhythmias; increasing anginal symptoms
• symptoms of fatigue; adverse change in pt’s appearance or attitude

Question 2

Vital status and blood levels for NOT BEING ALLOWED TO EXERCISE: (CHECK/ADD VALUES!!)

Answer 2

o Hemoglobin below 8 g/dL
o Platelets below 20,000/mL
o WBC’s below 5,000/mm3 accompanied by a fever

Question 3

Normal values for ABGs

Answer 3

ARTERIAL BLOOD GASES: used to assess effectiveness of gas exchange & in Dx of acute respiratory conditions

Normal Values
o pH: 7.35-7.45 (lower=resp or metabolic acidosis; high: metabolic or resp alkalosis)

o PaCO2: 35-45 mmHg

• Controlled by ventilation (ventilation control in brainstem)
• high= resp acidosis (from hypoventilation - COPD, flail chest, neuromuscular disorders, sleep apnea)  help with secretion clearance
• low = resp alkalosis (hyperventilation, pain or anxiety or breathlessness); mechanical vent

o HCO3: 22-28 (decreased: metabolic acidosis; increased: metabolic alkalosis)

o PaO2: 80-100 mmHg
- Determined by alveolar ventilation, ventilation/perfusion, FiO2

o SaO2: 95-100%