Treatments & Therapies

Spiroergometry – treatment, effects & risks

Spiroergometry

Spiroergometry is a diagnostic method for measuring cardiopulmonary performance. For this purpose, the so-called respiratory gases, oxygen and carbon dioxide, are measured during a defined physical exertion. The procedure is particularly important in pulmonary medicine and in therapy and follow-up monitoring.

What is spiroergometry?

Spiroergometry is a compound term from the two words spirometry and ergometry. The Latin word spiro means breathing, ergo comes from the Greek and means measure of work.

During spiroergometry, the patient is subjected to constant stress, for example on a treadmill, while breathing is controlled at the same time with a mask specially developed for this purpose. In addition, an electrocardiogram can also be derived. Overall, spiroergometry allows conclusions to be drawn about the performance and the reaction of metabolism , breathing, heart and circulation under stress.

The level of stress is determined by the doctor, because the patient’s health should not be endangered by excessive stress during the maneuver. During spiroergometry, also known as ergospirography or ergospirometry , certain parameters, i.e. measured values, are continuously recorded, which are of great importance for the diagnosis and progression of respiratory diseases in particular.

Function, effect & goals

Spiroergometry is firmly established in the medical disciplines of cardiology and pulmonology . Spiroergometers can also be found in many general medicine practices today. The examination can be performed on both children and adults and can last up to 30 minutes.

During a defined load, for example 10 minutes on a bicycle ergometer at 120 watts, relevant cardiovascular parameters such as pulse , blood pressure or ECG are recorded using body electrodes. These parameters can be viewed and evaluated directly by the doctor in real time. Spirometry measures pulmonary parameters through the breathing mask and therefore allows direct conclusions to be drawn about the lung function of a test subject.

With this combination of spirometry and ergometry, the current physical performance of a patient can be described very precisely. If you have specific questions about athletic performance or if you have restricted lung function, blood samples can also be taken from the earlobe or fingertip during spiroergometry. These capillary blood samples can then be tested for lactate or blood gases.

In the case of chronic lung diseases, such as COPD , the oxygen content of the blood usually drops significantly under physical stress. Spiroergometry is also used to monitor the progress of lung diseases or to monitor therapy. During spiroergometry, the load is usually continuously increased, so it is also a matter of answering the question of what maximum performance is possible. The organs involved in the provision of services, in particular the lungs, heart and skeletal muscles , can be assessed during the examination in their interaction.

A percussion or cardiac auscultation can also be performed by the doctor during spiroergometry. The maneuver is performed either on a treadmill or a stationary bike. The increase in performance takes place in previously selected load levels. Exhaled carbon dioxide, CO2 and oxygen consumption are measured through the breathing mask. The parameters collected can be compared with a reference table.

In addition to vital parameters such as pulse and blood pressure, respiratory rate, respiratory flow and pulmonary parameters such as one-second capacity and vital capacity are typically recorded during spiroergometry. If the patient reaches the limits of endurance, the so-called anaerobic threshold is reached. Glucose is then no longer completely burned by the metabolism and lactate is produced as a metabolic product. At the anaerobic threshold, the level of the lactate value provides valuable information on the muscular fatigability in connection with an oxygen deficit in lung diseases.

This anaerobic threshold is always the individual continuous performance limit of a subject. Physical training can influence the anaerobic threshold. If the performance of a patient deviates significantly from the normal values ​​for his gender and age group, then the underlying causes are pulmonary or cardiac or a combination of both. Oxygen deficits and thus premature fatigue during spiroergometry can also have completely different causes, such as anemia .

Risks, side effects & dangers

Spiroergometry is often performed on chronically ill patients to monitor the progression and therefore carries certain risks. Even healthy patients are catapulted to the edge of their individual physical capacity. Unforeseen events such as cardiac arrhythmias or hyperventilation can therefore occur during a maneuver.Spiroergometry should therefore only take place under medical supervision. 

The German Society for Pulmonary Medicine considers it mandatory to have an emergency set with adrenaline , intubation equipment and a ventilation mask available during spiroergometry. In patients with pulmonary pre-existing conditions, such as asthmatics or allergy sufferers , respiratory arrest can also occur under the stress. The possibility of immediate therapeutic intervention largely minimizes the consequences of such risks and side effects in everyday clinical practice.

Despite the standardized implementation of spiroergometry, the procedure is by no means free from possible measurement errors. In particular, the frequently occurring hyperventilation is regarded as a significant source of error. Even putting on the breathing mask can lead to psychologically triggered hyperventilation in some patients. In the subsequent performance diagnostics, this can lead to falsified results in respiratory compensation.

All parts of the device, i.e. breathing mask or hoses, are reused and must therefore be cleaned and sterilized very carefully. Otherwise, germ reservoirs can form unnoticed if hygienic requirements for cleaning the device are neglected, which means a potential risk of infection for the patient.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.