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Total haemoglobin mass, but not haemoglobin concentration, is associated with preoperative cardiopulmonary exercise testing-derived oxygen-consumption variables

Title data

Otto, James M. ; Plumb, James O. M. ; Wakeham, Denis J. ; Clissold, Eleri ; Loughney, L. ; Schmidt, Walter ; Montgomery, Hugh ; Grocott, Michael P. W. ; Richards, Toby:
Total haemoglobin mass, but not haemoglobin concentration, is associated with preoperative cardiopulmonary exercise testing-derived oxygen-consumption variables.
In: British Journal of Anaesthesia. Vol. 118 (1 May 2017) Issue 5 . - pp. 747-754.
ISSN 1471-6771
DOI: https://doi.org/10.1093/bja/aew445

Abstract in another language

Background
Cardiopulmonary exercise testing (CPET) measures peak exertional oxygen consumption ( V˙O2peak ) and that at the anaerobic threshold ( V˙O2 at AT, i.e. the point at which anaerobic metabolism contributes substantially to overall metabolism). Lower values are associated with excess postoperative morbidity and mortality. A reduced haemoglobin concentration ([Hb]) results from a reduction in total haemoglobin mass (tHb-mass) or an increase in plasma volume. Thus, tHb-mass might be a more useful measure of oxygen-carrying capacity and might correlate better with CPET-derived fitness measures in preoperative patients than does circulating [Hb].

Methods
Before major elective surgery, CPET was performed, and both tHb-mass (optimized carbon monoxide rebreathing method) and circulating [Hb] were determined.

Results
In 42 patients (83% male), [Hb] was unrelated to V˙O2 at AT and V˙O2peak ( r =0.02, P =0.89 and r =0.04, P =0.80, respectively) and explained none of the variance in either measure. In contrast, tHb-mass was related to both ( r =0.661, P <0.0001 and r =0.483, P =0.001 for V˙O2 at AT and V˙O2peak , respectively). The tHb-mass explained 44% of variance in V˙O2 at AT ( P <0.0001) and 23% in V˙O2peak ( P =0.001).

Conclusions
In contrast to [Hb], tHb-mass is an important determinant of physical fitness before major elective surgery. Further studies should determine whether low tHb-mass is predictive of poor outcome and whether targeted increases in tHb-mass might thus improve outcome.

Further data

Item Type: Article in a journal
Refereed: Yes
Institutions of the University: Faculties > Faculty of Cultural Studies > Department of Sport Science
Faculties > Faculty of Cultural Studies > Department of Sport Science > Professorship Sports Science IV
Faculties
Faculties > Faculty of Cultural Studies
Result of work at the UBT: Yes
DDC Subjects: 600 Technology, medicine, applied sciences > 610 Medicine and health
Date Deposited: 07 Sep 2017 12:26
Last Modified: 07 Sep 2017 12:33
URI: https://eref.uni-bayreuth.de/id/eprint/39244