Calculation algorithms for breath-by-breath alveolar gas exchange: the unknowns!

Several papers (algorithm papers) describe computational algorithms that assess alveolar breath-by-breath gas exchange by accounting for changes in lung gas stores. It is unclear, however, if the effects of the latter are actually considered in literature. We evaluated dissemination of algorithm papers and the relevant provided information. The list of documents investigating exercise transients (in 1998-2017) was extracted from Scopus database. Documents citing the algorithm papers in the same period were analyzed in full text to check consistency of the relevant information provided. Less than 8% (121/1522) of documents dealing with exercise transients cited at least one algorithm paper; the paper of Beaver et al. (J Appl Physiol 51:1662-1675, 1981) was cited most often, with others being cited tenfold less. Among the documents citing the algorithm paper of Beaver et al. (J Appl Physiol 51:1662-1675, 1981) (N = 251), only 176 cited it for the application of their algorithm/s; in turn, 61% (107/176) of them stated the alveolar breath-by-breath gas exchange measurement, but only 1% (1/107) of the latter also reported the assessment of volunteers' functional residual capacity, a crucial parameter for the application of the algorithm. Information related to gas exchange was provided consistently in the methods and in the results in 1 of the 107 documents. Dissemination of algorithm papers in literature investigating exercise transients is by far narrower than expected. The information provided about the actual application of gas exchange algorithms is often inadequate and/or ambiguous. Some guidelines are provided that can help to improve the quality of future publications in the field.