Discussion of interesting or befuddling cases related to pulmonary and critical care medicine.
Thursday, March 23, 2006
LVRS
Steve G. asks about lung volume reduction requirements. In a patient with heterogeneous emphysema in the upper lobes, what defines poor exercise tolerance? Is an exercise study necessary or can we use the 6 minute walk to evaluate? If so, how many meters would be considered poor?
A low exercise capacity was defined as a maximal workload at or below the sex-specific 40th percentile (25 W for women and 40 W for men) on cycle ergometry in the NETT study.
But how can we extrapolate the NETT data (i.e. 40 W) to the 6 minute hall walk (or can we)? Seems like we should be able to use the 6 min HW instead of a full fledged exercise study to determine whether someone has poor exercise tolerance...
Currently, we can't extrapolate to a 6 minute hall walk, if you want to evaluate it based on the NETT criteria. As far as I know, those criteria have not been compared to the 6 MHW in the context of LVRS.
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I think you could use a 6-minute HW. How heterogeneous is it? Would he also benefit from a quantitative Q scan?
A low exercise capacity was defined as a maximal workload at or below the sex-specific 40th percentile (25 W for women and 40 W for men) on cycle ergometry in the NETT study.
But how can we extrapolate the NETT data (i.e. 40 W) to the 6 minute hall walk (or can we)? Seems like we should be able to use the 6 min HW instead of a full fledged exercise study to determine whether someone has poor exercise tolerance...
Currently, we can't extrapolate to a 6 minute hall walk, if you want to evaluate it based on the NETT criteria. As far as I know, those criteria have not been compared to the 6 MHW in the context of LVRS.
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