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You are bidding on a 2007 Cosmed PFT Ergo 4 Stress Test:
While this unit was delivered in July 2007, it has only performed ~50 tests. Its capabilities include complete PFTs (spirometry, DLco, single-breath closing volumes, and N2-washout); Cardio-Pulmonary Exercise Testing (EKG and gas-exchange); and resting metabolic rate assessments. We can show your staff how to most efficiently utilize the equipment and discuss which ICD-9 and CPT codes work best for the testing performed. AED, Crash kit, and plenty of extra supplies (disposables and air tanks) are included for instant usage. Free delivery available for the greater Dallas-Fort Worth, TX area.
Benefits of CPXT:
1. for Pre-Op Assessment and unexplained Shortness of Breath:
** The ramp protocol and gas analysis allows for MEASUREMENT of functional capacity instead of estimating it ... Anaerobic Threshold (AT), Ventilatory equivalents, O2-Pulse, VO2peak are all measured using CPXT to give accurate, objective qualifications of risk assessment and potential causes of SOB.
** NUCs and Echos = rest; CPXT = during exercise/stress
** Much greater complications peri-operatively and post-operative with low AT despite NO ischemic EKG changes!!!
** Heart Failure - an anatomically NORMAL heart may still be seen with Diastolic Dysfunction.
** NUCs may miss moderate degree blockages in multi-vessel CAD cases (minimal to no change on EKG or NUC imaging).
** Ventilation versus Circulation - are the lungs playing a role in the SOB? CPXT looks at both circulatory systems and pulmonary systems with one test.
** No more starting an exercise protocol only to stop then start a chemical one; or order fewer chemicals (Adenosine, Dobutamine, etc) for those that cannot exercise to a target heart rate, especially given that some patients experience with chemical testing are nearly unbearable. Only about 2/3 effort is necessary to obtain adequate information for pre-op or disability report.
** Effort can be measured to substantiate malingering especially if AT is not reached.
2. Heart Failure and asymptomatic valvular diseased patients’ management:
** CPXT provides functional status and allows for objective tracking of their functional status (follow the decline in Anaerobic Threshold and VO2) to determine when surgery is necessary.
** Some asymptomatic MVP cases and others, may worsen with exercise, but the patient does not complain about that because he/she does not engage in activity.
** Using CPXT will keep your ultrasound and NUC equipment available for more appropriate candidates which will help those who need it more, get tested more quickly.
3. Maintain more control over your patients’ health care. Most patients (especially those with few risk factors / atypical symptoms) will produce a normal test.
4. The addition of gas exchange evaluation, coordinated with EKG data helps by increasing the sensitivity of the test (i.e. the likelihood of having a false-negative decreases).
Benefits of complete PFTs:
1. Pulmonary, like cardiac concerns, can go undetected (i.e. the patient may be asymptomatic, or attribute potential symptoms to being out-of-shape or getting older). A slowly progressing pulmonary problem allows the body to acclimate to the situation compensating more and more over time (masking symptoms). Allergy symptoms may appear similar to or even cause more severe pulmonary problems.
2. If an abnormal spirometry is noted, even in Pre-op cases, diffusion and total lung capacity should be assessed. Despite a normal spirometry, the diffusion capacity may be reduced, or hyperinflation could still be present. Also, inhaled insulin, long-term use of insulin, and cancer treatment drugs may ultimately negatively affect lung function. Gain a baseline and be able to track your patient’s possible pulmonary decline.
3. They are very easy to perform and have very little liability associated with performing them.
Benefits of RMR:
1. Assess possible hypoventilation (SOB, COPD, hypoxemia, fatigue, dizziness, etc.)
2. Evaluate disorders of metabolism involving liver, pancreas, kidneys, and adrenal glands (e.g. Diabetes, Thyroid dysfunction, HTN, cholesterol/lipid abnormalities, etc.); as well as celiac disease, menopause, and unexplained weight loss.
3. Objectively evaluate pre- and post- treatments (pulmonary and/or cardiac rehab [minimum of 4-6 weeks], gastric bypass, medication to control metabolism dysfunction, etc.) |
