ATS Pulmonary Function Laboratory Manual

ATS Pulmonary Function Laboratory Management & Procedure Manual | 3rd Edition

Test Procedure for Exercise Test for Assessment of Desaturation

(Continued from previous page)

Step Action 5.

Exercise protocol: • Exercise duration is typically 5–10 minutes in depending on the laboratory’s protocol. A minimum of 3 minutes of exercise is recommended. • Hall corridor or stairs 1. Have the subject walk at a vigorous pace or one they can maintain for 5–10 minutes 2. Have the subject walk on the stairs at the pre-determined walking cadence. • Treadmill 1. Speed and grade can be determined by the technologist based on the activity level that elicits dyspnea in a given patient. 2. Typically this is 1 mile per hour (mph), but may vary. 3. Increase or decrease the speed and grade as tolerated by the patient. • Cycle ergometer 1. Beginning workload: 40–80 RPMs at 15–20 watts 2. Increment workload as tolerated by the patient. 6. Record the post-exercise parameters:

• Total exercise time • End-exercise Sp O 2 • End-exercise heart rate • Blood pressure, if appropriate • Borg or Visual Analog Scale score • Any symptoms (e.g. chest pain, chest tightness, lightheadedness, etc.) Exercise end points: • Completing the pre-determined exercise time • Sp O 2 < 88% • Adverse symptoms • Patient complains of severe chest angina, tightness or wheezing • Lightheadedness, confusion, nausea, ataxia, pallor, etc. • Inappropriate tachycardia (> 160 bpm) • Volitional termination by the patient (i.e., cannot continue)

7.

O 2 titration with exercise: • Have the patient rest for 10 minutes prior to test. • Use the patient’s resting O 2 • Start the exercise protocol ( see above ) • Adjust the O 2 flow rate to maintain a Sp O 2 tioned under “Oxygen Titration” above. • Titration of patients on supplemental O 2

8.

flow rate if already titrated at rest, and/or start O 2

at 1–2 L/min.

between 90–92% using one of the two approaches men-

and using an O 2

conserving device can be a combination of

flow rate and conserving device settings.

adjustments to both O 2

• Exercise endpoints: 1. Same as above 2. Sp O 2

<88% with an O 2

flow rate of 6 L/min.

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