Oxygen saturation during daily activities in chronic obstructive pulmonary disease

Abstract

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.

Automated O2 titration improves exercise capacity in patients with hypercapnic chronic obstructive pulmonary disease: a randomised controlled cross-over trial

“…This could be related to insufficient oxygen flow rates to correct exercise-induced hypoxaemia during daily tasks. For example, 24-hour home-based SaO 2 monitoring performed in patients while breathing O 2 at their prescribed flow rate (1–3 L/min) showed inadequate oxygenation during daily tasks3 and mean SaO 2 of 88% during walking 4. Indeed, current recommendation is to increase O 2 flow rates during exercise by adding 1 L/min to resting O 2 flow, which might be insufficient.…”

Best practice in nursing care of dyspnea: The 6th vital sign in individuals with COPD

“…Oxygen prescriptions (duration and flow) should be based on arterial blood gas measurements and 6 minute walk tests results [80] . Longer term exposure to oxygen therapy (> 15 hr/day) over a number of years significantly improves survival [81,82] .…”

Preserving Oxygenation during Walking in Severe Chronic Obstructive Pulmonary Disease: Noninvasive Ventilation versus Oxygen Therapy

“…Thus, several studies have shown that simple, routine activities of daily life such as walking or stair-climbing result in exercise-induced hypoxemia in patients with severe COPD [2,3,4]. Therefore, the prevention of dyspnea and oxygen decline during exercise is of clinical importance, particularly in view of the fact that patients with severe COPD are at high risk of dying from cardiovascular complications following exercise-induced hypoxemia [5,6,7].…”