Real‐world estimate of the value of one metabolic equivalent in a population of patients planning major surgery

Real‐world estimate of the value of one metabolic equivalent in a population of patients planning major surgery

Background One metabolic equivalent (MET) is equal to resting oxygen consumption. The average value for one MET in humans is widely quoted as 3.5 mL/kg/min. However, this value was derived from a single male participant at the end of the 19th century and has become canonical. Several small studies h...

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Bibliographic Details
Published in:Internal medicine journal Vol. 52; no. 8; pp. 1409 - 1414
Main Authors: Douglas, Ned, Andrews, Grace, Altamimi, Hassanain, Wang, Andrew, Basto, Jarrod, Smith, Robert E. R., Taylor, Hugh E.
Format: Journal Article
Language:English
Published: Melbourne John Wiley & Sons Australia, Ltd 01-08-2022
Wiley Subscription Services, Inc
Subjects:
Anaerobic threshold
Body mass index
CPET
exercise physiology
MET
metabolic equivalent
Metabolism
Oxygen consumption
Patients
resting oxygen consumption
Surgery
metabolic equivalent
resting oxygen consumption
CPET
MET
exercise physiology
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Summary:Background One metabolic equivalent (MET) is equal to resting oxygen consumption. The average value for one MET in humans is widely quoted as 3.5 mL/kg/min. However, this value was derived from a single male participant at the end of the 19th century and has become canonical. Several small studies have identified varied estimates of one MET from widely varying populations. The ability of a patient to complete 4 MET (or 14 mL/kg/min) is considered an indicator of their fitness to proceed to surgery. Aims To define a typical value of one MET from a real‐world patient population, as well as determine factors that influenced the value. Methods A database of cardiopulmonary exercise testing (CPET) was interrogated to find a total of 1847 adult patients who had undergone CPET testing in the previous 10 years. From this database, estimates of oxygen consumption (VO2) at rest and at the anaerobic threshold and several other variables were obtained. The influence of age, body mass index (BMI), sex and the use of beta‐blockers was tested. Results The median resting VO2 at rest was 3.6 mL/kg/min (interquartile range (IQR): 3.0–4.2). Neither sex, age >65 years or the use of beta‐blockers produced a significant difference in resting VO2, while those with a BMI >25 kg/m2 had a significantly lower VO2 at rest (3.4 mL/kg/min vs 4.0 mL/kg/min; P < 0.001). Conclusions The estimate of 3.6 mL/kg/min for resting VO2 presented here is consistent with the previous literature, despite this being the first large study of its kind. This estimate can be safely used for pre‐operative risk stratification.
Bibliography:Conflict of interest: None.
Funding: This work was supported by the Department of Anaesthesia, Pain and Perioperative Medicine of Western Health, Melbourne, Victoria, Australia. No external, commercial or grant funding was used for the project.
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ISSN:1444-0903
1445-5994
DOI:10.1111/imj.15394