Spirometry was performed by three well-trained pulmonary technicians following the 1994 ATS recommendations [15 (link)], using a spirometer(Vmax-229, Sensor-Medics, Yorba Linda, CA, USA) for all subjects. The predicted forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were measured using the method of Morris [16 (link)]; the patients performed forced expiratory maneuvers until three measurements met the ATS guideline recommendations. The subjects performed a maximum of eight forced expirations; those who were unable to perform three expiratory maneuvers that met ATS guidelines were excluded. Two doses of fenoterol hydrobromide (Berotec®, Boehringer Ingelheim, Ingelheim, Germany) 200 μg were administered 1–2 min apart. The forced expirations were repeated 15 min after administration of the bronchodilator.
Vmax 229
Manufactured by Cardinal Health
Sourced in United States
The Vmax 229 is a laboratory instrument designed for quantitative spectroscopic analysis. It provides precise measurements of absorbance, transmittance, and fluorescence in various sample types. The core function of the Vmax 229 is to perform accurate and reliable spectroscopic analyses in a variety of research and testing applications.
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29 protocols using vmax 229
1
Spirometry Procedure for Lung Function Assessment
2
Maximal Symptom-Limited Treadmill CPET
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A maximal symptom-limited treadmill CPET was performed using the modified Bruce protocol (GE Marquette Series 2000 treadmill). Tha gas analysis was preceded by the calibration of the equipment. Minute ventilation, oxygen uptake and carbon dioxide production were acquired breath-by-breath, using a SensorMedics Vmax 229 gas analyser. The pVO2 was defined as the highest 30-second average achieved during exercise and was normalized for body mass.10 (link) The anaerobic threshold was determined by combining the standard methods (V-slope preferentially and ventilatory equivalents). The VE/VCO2 slope was calculated by least-squares linear regression, using data acquired throughout the whole exercise. Several composite parameters of CPET were also calculated. Patients were encouraged to perform exercise until the respiratory exchange ratio (RER) was ≥1.10.
3
Cardiopulmonary Exercise Testing Protocol
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, carbon dioxide production ( ) and were measured continuously using a breath-by-breath online system (Vmax 229, Sensor Medics, USA). , and RERpeak were defined as the highest 10-s mean values recorded before the subject’s volitional termination of each test.
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, carbon dioxide production ( ) and were measured continuously using a breath-by-breath online system (Vmax 229, Sensor Medics, USA). , and RERpeak were defined as the highest 10-s mean values recorded before the subject’s volitional termination of each test.
4
Comprehensive Lung Function Assessment and 6-Minute Walk Test
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Lung function tests were performed according to guidelines published by the European Respiratory Society and the American Thoracic Society with a Vmax229 Pulmonary Function Instrument (SensorMedics, Yorba Linda, CA, USA). Lung volumes (total lung capacity [TLC], vital capacity [VC], residual volume [RV]), spirometry (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV1]), FEV1/FVC ratio, and surface area for gas exchange (diffusing capacity of lungs for carbon monoxide [DLCO]) were measured. TLC was determined using a body plethysmograph (6200 Autobox; SensorMedics). DLCO was determined by the single-breath method using an infrared analyser (Vmax229; SensorMedics). The value of DLCO was adjusted to the haemoglobin concentration.18 (link) Lung function data are presented as the percentage of the predicted value. High-resolution CT scans of the chest were evaluated by two chest radiologists using established methods.19 (link)
The 6 min walk test was performed by respiratory therapists in the pulmonary rehabilitation centre according to published guidelines.20 (link) Repeats were performed at the same time of the day to minimise intraday variability. The distances walked by the patients during the 6-min walk test are presented as a percentage of the predicted value.21 (link)
The 6 min walk test was performed by respiratory therapists in the pulmonary rehabilitation centre according to published guidelines.20 (link) Repeats were performed at the same time of the day to minimise intraday variability. The distances walked by the patients during the 6-min walk test are presented as a percentage of the predicted value.21 (link)
5
Comprehensive Pulmonary Function Evaluation
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A pulmonary function testing system (Vmax 229, SensorMedics, Yorba Linda, California) was used to make the spirometric-static measurements of vital capacity (VC), according to standard guidelines [14 (link)]. For the measurement of maximal inspiratory pressure (MIP) at the residual volume and maximal expiratory pressure (MEP) at total lung capacity, patients breathed into a mouthpiece connected to a manometer. The maneuvers were repeated at least three times or until two identical readings were obtained. For each maneuver, the best result was kept for the study [15 ].
From the routinely performed daytime arterial or arterialized capillary blood gases, we recorded diurnal carbon dioxide tension (pCO2) and bicarbonate. The results of nocturnal oximetry, performed with a Covidien Nellcor oximeter were also collected (percentage of sleep time with oxygen saturation SaO2 <90%). We also recorded apnea hypopnea index (AHI) from the first available polysomnography after the initial visit.
From the routinely performed daytime arterial or arterialized capillary blood gases, we recorded diurnal carbon dioxide tension (pCO2) and bicarbonate. The results of nocturnal oximetry, performed with a Covidien Nellcor oximeter were also collected (percentage of sleep time with oxygen saturation SaO2 <90%). We also recorded apnea hypopnea index (AHI) from the first available polysomnography after the initial visit.
6
Maximal Cardiopulmonary Exercise Testing Protocol
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All patients underwent maximal cardiopulmonary exercise testing (CPET) as previously described,19 assessed during a maximal progressive exercise test on a cycle ergometer (Ergoline, Spirit 150, Bitz, Germany), using a ramp protocol with work rate increments of 5–10 W every minute until exhaustion. The patients were instructed to pedal at 60 rpm. The CPET was considered maximal when (i) maximal respiratory exchange ratio was higher than 1.10; (ii) peak HR was higher than 95% of age predicted; and (iii) despite verbal encouragement, the subject could no longer maintain the exercise intensity.20 Heart rate (HR) was continuously recorded at rest and during the graded exercise testing using a 12‐lead digital electrocardiogram (ERGO PC 13, MICROMED Biotechnology Ltda., Brasília—DF—Brazil). Peak oxygen consumption (peak VO2) was determined by means of gas exchange on a breath‐by‐breath basis in a computerized system (model Vmax 229, Sensor Medics, Buena Vista, CA). Peak VO2 was defined as the maximum attained VO2 at the end of the exercise period. Its value averaged from the last 30 s of the CPET.
7
Maximal Cardiopulmonary Exercise Testing
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Each subject performed a ramp-type progressive cycle ergometer exercise test using the SensorMedics metabolic system (Vmax 229, Yorba Linda, CA, United States). Following 3 min of sitting comfortably without pedaling (rest) on the cycle ergometer breathing through a mouth piece and 1 min of unloaded pedaling, the work rate (determined by weight and overall assessment of activity level) was incremented at 10–20 W/min to the limit of the participant's tolerance. Participants were vigorously encouraged during the high-intensity phases of the exercise protocol. Gas exchange was measured breath-by-breath and peak O2 was determined when RER ≥1.0 (25 (link)) and was calculated as the highest 20-s rolling average in the last minute of exercise in absolute values (l/min), relative to body mass (ml/kg/min) and lean body mass (ml/kg/min). Percent predicted peak VO2 was determined using published norms (26 ).
8
Cardiopulmonary Exercise Testing Protocol
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Maximal exercise capacity was determined during a cardiopulmonary exercise testing on a cycle ergometer (Ergoline‐Spirit150, DEU), using a ramp protocol with work rate increments of 5–10 W every minute until exhaustion as previously described.16 , 22 , 25 Briefly, metabolic parameters, as oxygen uptake (VO2) and carbon dioxide production, were determined by means of gas exchange on a breath‐by‐breath basis in a computerized system (Sensor Medics, Model‐Vmax‐229, USA). Peak VO2 was defined as the maximum attained VO2 at the end of the exercise period when the patient could no longer maintain the cycle ergometer velocity at 60 rpm. Anaerobic threshold was determined to occur at the breakpoint between the increase in the carbon dioxide output and VO2 (V‐slope) or at the point in which the ventilatory equivalent for oxygen and end‐tidal oxygen partial pressure curves reached their respective minimum values and began to rise. Respiratory compensation was determined to occur at the point at which ventilatory equivalent for carbon dioxide was lowest before a systematic increase and when end‐tidal carbon dioxide partial pressure reaches a maximum value and begins to decrease.42 In addition, we evaluated the peak workload (Watts) at end of the exercise.
9
Standardized Pulmonary Function Assessment
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According to American Thoracic Society/European Respiratory Society guidelines, all patients underwent post-bronchodilator pulmonary function testing (Vmax 229 and Autobox 6200; Sensormedics, Yorba Linda, CA, USA) including spirometry measurements.12 COPD patients inhaled 400 μg of salbutamol 20 minutes before testing. We measured dynamic spirometry values, FEV1, forced vital capacity (FVC), airway obstruction (FEV1/FVC), and resting slow vital capacity (VC), which represent a reference point of chest hyperinflation.
10
Assessing Asthma Control and Exercise-Induced Bronchoconstriction
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Spirometry was performed at baseline and 10-15 mins after exercise challenge. Spirometry included FVC, FEV1, and forced expiratory flow, mid expiratory phase (FEF25–75) measured in triplicate (Vmax229; Sensormedics, Yorba Linda, CA) according to American Thoracic Society (ATS) guidelines (13 ). If participants had ≥ 10% decrease in FEV1 following exercise challenge, then inhalation of albuterol was given and spirometry was repeated. All medications, including inhaled corticosteroids, were held for at least 24 hours prior to each visit.
Asthma control was assessed using the Asthma Control Questionnaire (14 (link)) before and after training intervention in participants with asthma.
Asthma control was assessed using the Asthma Control Questionnaire (14 (link)) before and after training intervention in participants with asthma.
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