Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts

IntroductionMetabolic simulators (MS) produce simulated human breaths for the purpose of verification of cardiopulmonary exercise test (CPET) equipment. MS should produce consistent identical breaths with known CO2 and O2 gas concentrations over a range of breath rates and tidal volumes. Reliability...

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Main Authors: Tjeu Souren, Edward Rose, Herman Groepenhoff
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-06-01
Series:Frontiers in Physiology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2021.667386/full
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author Tjeu Souren
Edward Rose
Herman Groepenhoff
author_facet Tjeu Souren
Edward Rose
Herman Groepenhoff
author_sort Tjeu Souren
collection DOAJ
description IntroductionMetabolic simulators (MS) produce simulated human breaths for the purpose of verification of cardiopulmonary exercise test (CPET) equipment. MS should produce consistent identical breaths with known CO2 and O2 gas concentrations over a range of breath rates and tidal volumes. Reliability of a CPET metabolic cart depends on ongoing quality control and maintenance of the device, including intermittent verification with a MS. We compared two MS devices against two standard CPET systems.MethodsThe Vacumed 17056 (Vacumetrics, Ventura, CA) and Relitech (Relitech Systems BV, Nijkerk, The Netherlands) were used with two standard metabolic carts (Vyntus CPX and Vyntus ONE, both Vyaire Medical, Mettawa, IL, United States). Tidal volume (VT) was set at 2 and 3 L and breathing frequency ranged from 20 to 80 breaths per minute for each MS. At each set point, we measured three sets of 40 breaths. Primary outcome parameters collected were VT, oxygen consumption (v.O2), carbon dioxide production (v.CO2), and respiratory exchange ratio (RER).ResultsVT, RER, v.O2, and v.CO2 results as obtained from both MS were all within the limits of acceptability, at both tidal volume settings, and all ventilatory rates. No significant trends were identified for either MS device. The Relitech MS produced tidal volumes that were closer to the target VT for both CPET carts at both VT and all rates, but the results of both MS were within acceptable ranges.ConclusionVerification of CPET equipment using either the VM or RT metabolic simulator, producing highly accurate and predictable simulated breaths of known composition, enabling CPET laboratory managers to rely on subject test data obtained during cardiopulmonary exercise testing.
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spelling doaj.art-5b98fb7502364f939ada3fbb527be4212022-12-21T22:07:55ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-06-011210.3389/fphys.2021.667386667386Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test CartsTjeu Souren0Edward Rose1Herman Groepenhoff2Independent Consultant, Utrecht, NetherlandsIndependent Consultant, Novi, MI, United StatesVyaire Medical, Mettawa, IL, United StatesIntroductionMetabolic simulators (MS) produce simulated human breaths for the purpose of verification of cardiopulmonary exercise test (CPET) equipment. MS should produce consistent identical breaths with known CO2 and O2 gas concentrations over a range of breath rates and tidal volumes. Reliability of a CPET metabolic cart depends on ongoing quality control and maintenance of the device, including intermittent verification with a MS. We compared two MS devices against two standard CPET systems.MethodsThe Vacumed 17056 (Vacumetrics, Ventura, CA) and Relitech (Relitech Systems BV, Nijkerk, The Netherlands) were used with two standard metabolic carts (Vyntus CPX and Vyntus ONE, both Vyaire Medical, Mettawa, IL, United States). Tidal volume (VT) was set at 2 and 3 L and breathing frequency ranged from 20 to 80 breaths per minute for each MS. At each set point, we measured three sets of 40 breaths. Primary outcome parameters collected were VT, oxygen consumption (v.O2), carbon dioxide production (v.CO2), and respiratory exchange ratio (RER).ResultsVT, RER, v.O2, and v.CO2 results as obtained from both MS were all within the limits of acceptability, at both tidal volume settings, and all ventilatory rates. No significant trends were identified for either MS device. The Relitech MS produced tidal volumes that were closer to the target VT for both CPET carts at both VT and all rates, but the results of both MS were within acceptable ranges.ConclusionVerification of CPET equipment using either the VM or RT metabolic simulator, producing highly accurate and predictable simulated breaths of known composition, enabling CPET laboratory managers to rely on subject test data obtained during cardiopulmonary exercise testing.https://www.frontiersin.org/articles/10.3389/fphys.2021.667386/fullcardiopulmonary exercise testmetabolic simulatorrespiratory exchange ratiocalibrationmetabolic cartVyntus ONE
spellingShingle Tjeu Souren
Edward Rose
Herman Groepenhoff
Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts
Frontiers in Physiology
cardiopulmonary exercise test
metabolic simulator
respiratory exchange ratio
calibration
metabolic cart
Vyntus ONE
title Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts
title_full Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts
title_fullStr Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts
title_full_unstemmed Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts
title_short Comparison of Two Metabolic Simulators Used for Gas Exchange Verification in Cardiopulmonary Exercise Test Carts
title_sort comparison of two metabolic simulators used for gas exchange verification in cardiopulmonary exercise test carts
topic cardiopulmonary exercise test
metabolic simulator
respiratory exchange ratio
calibration
metabolic cart
Vyntus ONE
url https://www.frontiersin.org/articles/10.3389/fphys.2021.667386/full
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AT hermangroepenhoff comparisonoftwometabolicsimulatorsusedforgasexchangeverificationincardiopulmonaryexercisetestcarts