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Application of the optimized CO-rebreathing method for determination of hemoglobin mass in patients with polycythemia vera.
Ann Hematol. 2014 Jul; 93(7):1159-65.AH

Abstract

Determination of red cell volume (RCV) might contribute to establishing the diagnosis of polycythemia vera (PV). A novel simplified method to detect RCV through CO rebreathing is nowadays applied in healthy young individuals but was not tested in a clinical or PV setting. The aim of the present study is to evaluate whether this spirometric approach is applicable in older subjects and contributes to PV diagnosis in a proof-of-concept approach. At first, RCV was determined by the optimized CO-rebreathing method in healthy subjects >50 years of age (n = 81, age 66 ± 9 years). Failure rate and age distribution of subjects who failed with CO rebreathing were analyzed. Then, RCV was measured in male PV patients (n = 7) and compared to healthy male controls (n = 35). RCV values in relation to several anthropometric references (body weight, body surface area (BSA), lean body mass (LBM)) were calculated to determine the sensitivity and specificity of established RCV thresholds when using optimized CO rebreathing. In healthy subjects, test failure rate was 9.9 %, but failure was not associated with age. Sensitivity and specificity (sens/spec) to detect PV was 100 %/83 % using the criteria of the PV study group. Using criteria based on BSA, sens/spec was 14 %/100 %. An arbitrary threshold of 50 ml/kg LBM yielded sens/spec of 100 %/97 %. In conclusion, this proof-of-concept indicates that optimized CO rebreathing is applicable in older subjects and allows determining RCV for the diagnosis of PV. Normalized values for RCV measures obtained from CO rebreathing are needed to grant sufficient sensitivity and/or specificity.

Authors+Show Affiliations

Department of Exercise Medicine and Sport, University Hospital Freiburg, Hugstetterstr. 55, 79095, Freiburg, Germany, christoph.ahlgrim@uniklinik-freiburg.de.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24488226

Citation

Ahlgrim, C, et al. "Application of the Optimized CO-rebreathing Method for Determination of Hemoglobin Mass in Patients With Polycythemia Vera." Annals of Hematology, vol. 93, no. 7, 2014, pp. 1159-65.
Ahlgrim C, Schumacher YO, Wrobel N, et al. Application of the optimized CO-rebreathing method for determination of hemoglobin mass in patients with polycythemia vera. Ann Hematol. 2014;93(7):1159-65.
Ahlgrim, C., Schumacher, Y. O., Wrobel, N., Waller, C. F., & Pottgiesser, T. (2014). Application of the optimized CO-rebreathing method for determination of hemoglobin mass in patients with polycythemia vera. Annals of Hematology, 93(7), 1159-65. https://doi.org/10.1007/s00277-014-2020-5
Ahlgrim C, et al. Application of the Optimized CO-rebreathing Method for Determination of Hemoglobin Mass in Patients With Polycythemia Vera. Ann Hematol. 2014;93(7):1159-65. PubMed PMID: 24488226.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Application of the optimized CO-rebreathing method for determination of hemoglobin mass in patients with polycythemia vera. AU - Ahlgrim,C, AU - Schumacher,Y O, AU - Wrobel,N, AU - Waller,C F, AU - Pottgiesser,T, Y1 - 2014/02/01/ PY - 2013/12/19/received PY - 2014/01/21/accepted PY - 2014/2/4/entrez PY - 2014/2/4/pubmed PY - 2014/8/5/medline SP - 1159 EP - 65 JF - Annals of hematology JO - Ann. Hematol. VL - 93 IS - 7 N2 - Determination of red cell volume (RCV) might contribute to establishing the diagnosis of polycythemia vera (PV). A novel simplified method to detect RCV through CO rebreathing is nowadays applied in healthy young individuals but was not tested in a clinical or PV setting. The aim of the present study is to evaluate whether this spirometric approach is applicable in older subjects and contributes to PV diagnosis in a proof-of-concept approach. At first, RCV was determined by the optimized CO-rebreathing method in healthy subjects >50 years of age (n = 81, age 66 ± 9 years). Failure rate and age distribution of subjects who failed with CO rebreathing were analyzed. Then, RCV was measured in male PV patients (n = 7) and compared to healthy male controls (n = 35). RCV values in relation to several anthropometric references (body weight, body surface area (BSA), lean body mass (LBM)) were calculated to determine the sensitivity and specificity of established RCV thresholds when using optimized CO rebreathing. In healthy subjects, test failure rate was 9.9 %, but failure was not associated with age. Sensitivity and specificity (sens/spec) to detect PV was 100 %/83 % using the criteria of the PV study group. Using criteria based on BSA, sens/spec was 14 %/100 %. An arbitrary threshold of 50 ml/kg LBM yielded sens/spec of 100 %/97 %. In conclusion, this proof-of-concept indicates that optimized CO rebreathing is applicable in older subjects and allows determining RCV for the diagnosis of PV. Normalized values for RCV measures obtained from CO rebreathing are needed to grant sufficient sensitivity and/or specificity. SN - 1432-0584 UR - https://www.unboundmedicine.com/medline/citation/24488226/Application_of_the_optimized_CO_rebreathing_method_for_determination_of_hemoglobin_mass_in_patients_with_polycythemia_vera_ L2 - https://dx.doi.org/10.1007/s00277-014-2020-5 DB - PRIME DP - Unbound Medicine ER -