Arterial Oxygen Saturation During Meals in Patients With Severe Chronic Obstructive Pulmonary Disease

Brown, S E; Casciari, Raymond J.; Light, Richard W.

doi:10.1097/00007611-198302000-00013

Cited by 38 publications

(21 citation statements)

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“…6,19 Also, large falls in SaO 2 during meals are more common in patients with chronic obstructive pulmonary diseases (COPD), whose resting mean SaO 2 is on the steep portion of the oxygen dissociation curve. 3 However, in our study there were only 14 stroke and 6 elderly control patients who had preexisting breathing problems. Therefore, there were too few patients with chest disease to expect to see such large changes in median SaO 2 .…”

Section: Rowat Et Al Feeding Of Acute Stroke Patients 2137mentioning

confidence: 69%

“…As in previous studies, significant desaturation was defined as a fall in SaO 2 of Ն3% 8,11 and hypoxemia was defined as SaO 2 of Յ90% saturation. 3 Appropriate statistical tests (specified in the text) were used for dichotomized variables. Statistical significance was taken at the 5% level.…”

Section: Discussionmentioning

confidence: 99%

“…1 A fall in oxygenation could adversely affect the vulnerable ischemic brain lesion 2 and therefore reduce the chance of a good clinical outcome after stroke. Hypoxemia may increase during eating, [3][4][5] and acute stroke patients may be specifically affected, because approximately one half have swallowing problems in the first weeks after the event and in many this may not be recognized. 6,7 Previous investigations of patients with stroke have explored changes in arterial oxygen saturation (SaO 2 ), but only during a swallowing assessment performed by a speech and language therapist 8 or during videofluoroscopy, 9 -11 and then just as a method to detect clinically silent aspiration.…”

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Does Feeding Alter Arterial Oxygen Saturation in Patients With Acute Stroke?

Rowat

Wardlaw

Dennis

et al. 2000

Stroke

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Background and Purpose-We measured arterial oxygen saturation (SaO 2 ) during eating in acute stroke patients to establish the frequency of any meal-related hypoxemia, which could further damage already vulnerable brain tissue. Methods-Stroke patients (Յ12 days from stroke onset) classified as "safe to feed orally" were compared with elderly hospitalized (for nonneurological causes) and young healthy controls. SaO 2 was measured noninvasively at the bedside by pulse oximetry continuously for 10 minutes before the patient ate a meal, during the meal, and for 10 minutes after completion of the meal. Results-The median baseline SaO 2 was significantly lower in stroke patients (nϭ106, 95.7%) than elderly (nϭ50, 96.7%) or young control subjects (nϭ20, 97.9%; PϽ0.001). There was a small decrease in the median SaO 2 during eating in stroke and elderly patients (95.6%, Pϭ0.08, and 96.3%, Pϭ0.004, respectively) but not in young controls. Only stroke patients had a significantly lower median SaO 2 after completion of the meal (95.4%, PϽ0.001). SaO 2 of Յ90% during and after eating occurred in 24% of stroke and 16% of elderly patients but not in young controls, and it was significantly more common in those who had SaO 2 of Յ90% during the baseline recordings (PՅ0.003). Conclusions-Eating a meal was associated with a small fall in median SaO 2 among stroke and elderly patients, but only in stroke patients did this persist for at least 10 minutes after eating. A quarter of stroke patients had episodes in which the SaO 2 fell to Յ90% saturation (ie, hypoxemia) during or after eating, although this rarely coincided exactly with swallowing and was more common in patients who also experienced desaturation during the baseline recordings. Further studies are required to establish whether these changes are clinically important. (Stroke. 2000;31:2134-2140.)

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Section: Rowat Et Al Feeding Of Acute Stroke Patients 2137mentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Does Feeding Alter Arterial Oxygen Saturation in Patients With Acute Stroke?

Rowat

Wardlaw

Dennis

et al. 2000

Stroke

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“…During both eating and walking, the severity of desaturations, but not their number, was related to the mean saturation at rest. BROWN et al [25] and SCHOLS et al [26] reported transient desaturations during meals in COPD patients. In both studies, this occurred only in a subgroup of patients who were already hypoxaemic at rest.…”

Section: Discussionmentioning

confidence: 98%

Oxygen saturation during daily activities in chronic obstructive pulmonary disease

Schenkel¹,

Burdet²,

Muralt³

et al. 1996

Eur Respir J

109

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O Ox xy yg ge en n s sa at tu ur ra at ti io on n d du ur ri in ng g d da ai il ly y a ac ct ti iv vi it ti ie es s i in n c ch hr ro on ni ic c o ob bs st tr ru uc ct ti iv ve e p pu ul lm mo on na ar ry y d di is se ea as se e During a rehabilitation programme, we studied 30 patients with moderate-tosevere COPD (median forced expiratory volume in one second (FEV1) 37% of predicted), without marked hypoxaemia (median arterial oxygen tension (Pa,O 2 ) 9.1 kPa). Arterial oxygen saturation (Sa,O 2 ) was assessed by pulse oximetry during night (8 h) and day (10.5 h). The mean and minimal Sa,O 2 were calculated, and desaturations were defined as Sa,O 2 falls >4%·h -1 . Daily activities were identified by the patients as resting, eating, washing, nebulization therapy and walking.Mean Sa,O 2 was lower during the night (88%) than during the day (89%). In contrast, minimal Sa,O 2 was lower during the day (69%) than during the night (72%), and the number of desaturations was higher during the day (8.6 desaturations·h -1 ) than during the night (6.8 desaturations·h -1 ). Mean Sa,O 2 was 88% during walking, which was lower than during resting (90%), nebulization (90%), and meals (89%). The number of desaturations was higher during walking (13.1 desaturations·h -1 ), washing (12.6 desaturations·h -1 ), and eating (9.2 desaturations·h -1 ) than during resting (5.3 desaturations·h -1 ).We conclude that daily activities, such as walking, washing and eating, are associated with transient oxygen desaturation in patients with moderate-to-severe chronic obstructive pulmonary disease, even without marked resting hypoxaemia.

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“…It was apparent that not all studies could be easily classifi ed using the numerical scale due to overlap in design criteria. Therefore, letter grades (Column 1, ; 6 were Level C [36][37][38][39][40][41] ; and 6 were Level D 16,[47][48][49][50][51] . Seven of the 47 articles investigated the relationship between COPD and oropharyngeal dysphagia 8,[11][12][13][14][15][16] .…”

Section:  Methodsmentioning

confidence: 99%