The Hyperventilation 5 VOSTFR‑ model provides a robust, physiologically grounded classification that enables rapid, targeted therapy, markedly shortening the time to biochemical and clinical recovery. Implementation in emergency settings may improve patient outcomes and reduce resource utilization.
To validate the 5 VOSTFR‑ model in a prospective cohort of adult patients presenting with acute hyperventilation and to assess the efficacy of a targeted, axis‑specific therapeutic algorithm.
The framework proposes a five‑axis model: Hyperventilation 5 VOSTFR-
¹ Department of Pulmonary Medicine, University Hospital, City, Country ² Department of Emergency Medicine, University Hospital, City, Country ³ Institute of Clinical Physiology, University of Science, City, Country
| Axis | Measurement | Equipment | Scoring (0‑3) | |------|-------------|-----------|--------------| | V | VE (L/min) via portable metabolic cart | COSMED K5 | 0 ≤ 15, 1 = 15‑25, 2 = 25‑35, 3 > 35 | | O | RRV (SD of inter‑breath intervals) | Respiratory inductance plethysmography | 0 ≤ 0.1 s, 1 = 0.1‑0.3 s, 2 = 0.3‑0.5 s, 3 > 0.5 s | | S | HR and plasma norepinephrine (point‑of‑care assay) | ECG & handheld assay | 0 ≤ 80 bpm & < 200 pg/mL, 1 = 80‑100 bpm or 200‑400 pg/mL, 2 = 100‑120 bpm or 400‑600 pg/mL, 3 > 120 bpm or > 600 pg/mL | | T | Forehead skin temperature & sweat rate (micro‑sweat sensor) | Infrared thermometer & wearable sensor | 0 ≤ 0 mg/min, 1 = 0‑5 mg/min, 2 = 5‑10 mg/min, 3 > 10 mg/min | | F | PaCO₂ (ABG) | Portable blood gas analyzer | 0 = 30‑35 mmHg, 1 = 25‑30 mmHg, 2 = 20‑25 mmHg, 3 < 20 mmHg | The Hyperventilation 5 VOSTFR‑ model provides a robust,
Hyperventilation 5 VOSTFR‑: A Novel Classification and Therapeutic Framework for Acute Respiratory Dysregulation
Hyperventilation, VOSTFR, respiratory physiology, acute care, targeted therapy, ventilatory control 1. Introduction Hyperventilation, defined as an increase in alveolar ventilation that exceeds metabolic CO₂ production, leads to arterial hypocapnia (PaCO₂ < 35 mmHg) and a cascade of neuro‑vascular and metabolic effects (Brown & Smith, 2021). While often benign, severe or prolonged episodes can precipitate cerebral vasoconstriction, tetany, arrhythmias, and, in extreme cases, loss of consciousness (Klein et al., 2020). The framework proposes a five‑axis model: ¹ Department
Baseline characteristics were balanced (Table 1).