<p>Factors Associated with Exercise-Induced Desaturation in Patients with Chronic Obstructive Pulmonary Disease</p>

Abstract

Purpose The 6-min walk test (6MWT) is a useful tool to assess the physiologic function in patients with chronic obstructive pulmonary disease (COPD). The recent study showed that patients with COPD with oxygen desaturation during the 6MWT had an increased risk of exacerbation and death compared with those without oxygen desaturation. This study aimed to explore the potential risk factors for exercise-induced desaturation (EID) in patients with COPD. Patients and Methods Adult patients with COPD were enrolled from the Chang Gung Research Database between January 2013 and January 2017. Age, sex, body mass index, underlying diseases, medications, and results of the pulmonary function tests and 6MWT were retrospectively collected and analyzed. Results Among 1768 patients with COPD, 932 (52.7%) had oxygen desaturation, and the other 836 (47.3%) had no desaturation during the 6MWT. The patients with EID had a shorter 6-min walk distance than those without desaturation (352.08±120.29 vs 426.56±112.56, p<0.0001). In the multivariate logistic regression analysis, older age, female sex, lower forced expiratory volume in 1 s, and comorbidity with atrial fibrillation (AF) were associated with oxygen desaturation during the 6MWT. Patients with EID had higher exacerbation frequency than those without desaturation in the 1-year follow-up period (0.59±1.50 vs 0.34±1.26, p<0.0001). Patients with COPD with AF also had a higher rate of exacerbation requiring emergency department visit or hospitalization in the 1-year follow-up. Conclusion This study demonstrates that older age, low FEV1, and female sex are risk factors for EID. Desaturation during 6MWT is related to frequent acute exacerbation of COPD in the 1-year follow-up.

Associations of Exercise Tolerance and Clinical Parameters in Japanese Patients With Chronic Obstructive Pulmonary Disease: Impact of Skeletal Muscle

“…For example, low-level physical activity, percent predicted forced expiratory volume in one second (%FEV 1 ), 6-minute walk distance, body mass index (BMI), and a high frequency of exacerbations are significantly associated with mortality in COPD patients 3,4 . We and others have also reported that low-level pulmonary function, exercise tolerance (including 6-minute walk distance and exercise-induced desaturation), and BMI are correlated with a high frequency of exacerbations [5][6][7][8] , indicating that evaluations of exercise tolerance and body composition, in addition to pulmonary function, are important for predicting the clinical course of COPD.…”

Exercise Intolerance and Oxygen Desaturation in Patients with Parkinson’s Disease: Triggers for Respiratory Rehabilitation?

“…The following day (day 16), patients performed the 6 min walk test (6MWT) [ 32 ] with the distance walked measured in meters and % of predicted meters, oximetry at rest (SpO 2 %), mean SpO 2 %, and minimum SpO 2 (nadir) (Spirodoc, MIR Medical International Research, USA). The numbers of patients with reduced (<80% of predicted meters) and severely reduced (<50% of predicted meters) exercise tolerance and the number of patients with oxygen desaturation identified by a delta saturation (basal–mean)% > 4% [ 33 ] were recorded.…”

“…The following day (day 16), patients performed the 6 min walk test (6MWT) [32] with the distance walked measured in meters and % of predicted meters, oximetry at rest (SpO 2 %), mean SpO 2 %, and minimum SpO 2 (nadir) (Spirodoc, MIR Medical International Research, USA). The numbers of patients with reduced (<80% of predicted meters) and severely reduced (<50% of predicted meters) exercise tolerance and the number of patients with oxygen desaturation identified by a delta saturation (basal-mean)% > 4% [33] were recorded. The rehabilitation program was individually tailored to each patient, and possible components of global motor training were stretching exercises; passive, active-assisted, and active mobilization exercises; neuromuscular strengthening exercises; exercises for posture control; walking training with and without external cueing or on a treadmill; lung expansion breathing exercises; exercises for the improvement of language; communication and writing; exercises for dysphagia [19].…”

Management of musculoskeletal pain in patients with idiopathic pulmonary fibrosis: a review

“…For patients who are breathless on exertion and have a desaturation on exertion <90%, ambulatory oxygen should be considered if this leads to improved exercise capacity or reduced breathlessness. Oxygen administration is associated with decreased exertional dyspnea and improved exercise capacity by increasing cardiac output and arterial oxygen content (76,77).…”