Effect of ambulatory oxygen on exertional dyspnea in IPF patients without resting hypoxemia

Nishiyama, Osamu; Miyajima, Hiroyuki; Fukai, Yumi; Yamazaki, Ryo; Satoh, Ryuji; Yamagata, Toshiyuki; Sano, Hiroyuki; Iwanaga, Takashi; Higashimoto, Yuji; Nakajima, Hirokazu; Kumakura, Hiroaki; Tohda, Yuji

doi:10.1016/j.rmed.2013.05.015

Cited by 78 publications

(76 citation statements)

References 29 publications

(26 reference statements)

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“…−0.37 (95% CI −0.50-−0.24) [164]. In patients with ILD, also dyspnoeic at rest, the effects of ambulatory oxygen therapy on dyspnoea (CR-10) in hypoxaemic [165] and nonhypoxaemic subjects parallel those described for COPD [166].…”

Section: Discussionmentioning

confidence: 71%

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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This document reviews 1) the measurement properties of commonly used exercise tests in patients with chronic respiratory diseases and 2) published studies on their utilty and/or evaluation obtained from MEDLINE and Cochrane Library searches between 1990 and March 2015.Exercise tests are reliable and consistently responsive to rehabilitative and pharmacological interventions. Thresholds for clinically important changes in performance are available for several tests. In pulmonary arterial hypertension, the 6-min walk test (6MWT), peak oxygen uptake and ventilation/carbon dioxide output indices appear to be the variables most responsive to vasodilators. While bronchodilators do not always show clinically relevant effects in chronic obstructive pulmonary disease, high-intensity constant work-rate (endurance) tests (CWRET) are considerably more responsive than incremental exercise tests and 6MWTs. High-intensity CWRETs need to be standardised to reduce interindividual variability. Additional physiological information and responsiveness can be obtained from isotime measurements, particularly of inspiratory capacity and dyspnoea. Less evidence is available for the endurance shuttle walk test. Although the incremental shuttle walk test and 6MWT are reliable and less expensive than cardiopulmonary exercise testing, two repetitions are needed at baseline. All exercise tests are safe when recommended precautions are followed, with evidence suggesting that no test is safer than others. @ERSpublications A review of exercise testing to evaluate interventions aimed to improve exercise tolerance in respiratory patients

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Section: Discussionmentioning

confidence: 71%

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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“…Whether the effect of oxygen therapy is related to a placebo effect remains subject to debate. In a controlled study, supplemental oxygen given at exercise in IPF patients with exertional arterial hypoxaemia but without resting arterial hypoxaemia failed to improve the 6-min walk distance and dyspnoea in comparison with placebo (air), despite improvements in arterial haemoglobin saturation [133], while another study reported beneficial effects with regard to endurance time and dyspnoea [134]. Indirect evidence suggests key roles of dead space ventilation in the genesis of dyspnoea, although the lack of a possibility to experimentally amend the VD/VT ratio precludes definitive demonstration.…”

Section: How Do Physiological Alterations Integrate In Ipf? Exercise mentioning

confidence: 95%

Physiology of the lung in idiopathic pulmonary fibrosis

et al. 2018

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The clinical expression of idiopathic pulmonary fibrosis (IPF) is directly related to multiple alterations in lung function. These alterations derive from a complex disease process affecting all compartments of the lower respiratory system, from the conducting airways to the lung vasculature. In this article we review the profound alterations in lung mechanics (reduced lung compliance and lung volumes), pulmonary gas exchange (reduced diffusing capacity, increased dead space ventilation, chronic arterial hypoxaemia) and airway physiology (increased cough reflex and increased airway volume), as well as pulmonary haemodynamics related to IPF. The relative contribution of these alterations to exertional limitation and dyspnoea in IPF is discussed.

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“…1 Currently, there are no randomised controlled trials to demonstrate that ambulatory oxygen therapy is effective in achieving these aims in patients with IPF, thus, assessment on an individual basis is necessary. 17 The thorax survey suggested significant support for ambulatory oxygen therapy, but variation when it was offered to patients. A 6 min walk or shuttle walk test will provide the most accurate indication of exercise-induced desaturation and the required level of oxygen supplementation.…”

Section: Ambulatory Oxygenmentioning

confidence: 99%

Improving care for patients with idiopathic pulmonary fibrosis (IPF) in the UK: a round table discussion

Thickett

Kendall

Spencer

et al. 2014

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Effect of ambulatory oxygen on exertional dyspnea in IPF patients without resting hypoxemia

Cited by 78 publications

References 29 publications

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Physiology of the lung in idiopathic pulmonary fibrosis

Improving care for patients with idiopathic pulmonary fibrosis (IPF) in the UK: a round table discussion

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