Predictors of Oxygen Desaturation During Submaximal Exercise in 8,000 Patients

Hadeli, Khaled; Siegel, Erin M.; Sherrill, Duane L.; Beck, Ken C.; Enright, Paul

doi:10.1378/chest.120.1.88

Cited by 97 publications

(74 citation statements)

References 15 publications

(18 reference statements)

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“…In a series of 8,000 patients no complications (symptoms of cardiovascular collapse) developed, even though half the patients were elderly and therefore had a relatively high prevalence of cardiovascular disease. Other studies reported no major problems with step tests [18].…”

Section: Discussionmentioning

confidence: 89%

“…It is legally compulsory in Italy for all persons wishing to engage in competitive sports [13]. The 3-min step test is also used to assess exercise capacity in children with cystic fibrosis [8,14,15], to evaluate the effect of a course of intravenous antibiotics on exercise tolerance [16], to study candidates for lung transplantation [17], and to determine the risk of oxygen desaturation during exercise [18].…”

mentioning

confidence: 99%

See 1 more Smart Citation

3‐Min step test and treadmill exercise for evaluating exercise-induced asthma

Tancredi¹,

Quattrucci²,

Scalercio³

et al. 2004

Eur Respir J

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A simple exercise test would be useful for detecting exercise-induced asthma, a common problem in asthmatic children. The current study compared the 3-min step test with treadmill exercise for evaluating exercise-induced asthma in asthmatic children and assessed whether responses to both tests are influenced by baseline lung function and habitual physical activity.A series of 154 asthmatic children (84 male children; mean age 12.9 ¡ 0.9 yrs) underwent a 3-min step-test and treadmill testing on different days within a week at least 24 h apart. Before both tests each subject did spirometry to obtain the baseline forced expiratory volume in one second (FEV1). After both exercise challenges all subjects did serial spirometry and the lowest FEV1 recorded over time was used to calculate the fall in FEV1 expressed as a percentage of the measured pre-exercise (baseline) value (% fall in FEV1) and the area above the FEV1 curve (AAC 0-30 min ) expressed as a percentage of the pre-exercise value. Changes in both exercise variables were also analysed in percentile subgroups defined by questionnaire answers on habitual physical activity in hours.The mean % fall in FEV1 was significantly higher for treadmill exercise than for the step test (15.0¡7.5 versus 11.7¡5.9); and the AAC 0-30 min was larger for treadmill than for the step test (-261.6¡139.9% versus -197.3¡105.0% min). In all subgroups defined by habitual physical activity the mean % fall in FEV1 decreased more after treadmill exercise than after the step test. After step test and treadmill exercise no significant correlation was found between % fall in FEV1 and baseline lung function, or between % fall in FEV1 among groups defined by habitual physical activity.Although the 3-min step test yields a lower % fall in forced expiratory volume in one second (FEV1) and a lower value of the area above the FEV1 curve than treadmill testing, it is a quick, economical, reproducible and portable alternative procedure for identifying exercise-induced asthma in outpatients and epidemiological studies. Baseline lung function and habitual physical activity have no influence on the amount or duration of exercise-induced asthma.

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Section: Discussionmentioning

confidence: 89%

mentioning

confidence: 99%

3‐Min step test and treadmill exercise for evaluating exercise-induced asthma

Tancredi¹,

Quattrucci²,

Scalercio³

et al. 2004

Eur Respir J

View full text Add to dashboard Cite

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“…Only in cases when high DL,CO is accompanied by a high resting Sp,O 2 (i.e. o95% at sea level) does DL,CO have an elevated negative predictive value [84], but in a large retrospective study, overall sensitivity and specificity, determined by receiver operating curve analysis, were both 75% with a cut-off point of 62% pred for DL,CO [85].…”

Section: Arterial Oxygen Desaturation During Exercisementioning

confidence: 90%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

Eur Respir J

551

390

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Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest.For symptom-limited incremental exercise, CPET indices, such as peak O 2 uptake (V9O 2 ), V9O 2 at lactate threshold, the slope of the ventilation-CO 2 output relationship and the presence of arterial O 2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable.In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) ''When should an evaluation of exercise intolerance be sought?''; 2) ''Which particular form of test should be asked for?''; and 3) ''What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?''

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“…Previous studies suggest that the major causes of exercise desaturation in patients with severe COPD are increases in venous admixture and relative hypoventilation during exercise (15). Other studies have documented exercise hypoxemia in patients with lung disease, and the factors found to predict its occurrence include a baseline saturation below 96% and a low diffusion capacity (16,17).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Nasal Cannulas and the OxyArm in Patients Requiring Chronic Domiciliary Oxygen Therapy

Paul

Otvos

2006

Canadian Respiratory Journal

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OBJECTIVES: The present study was designed to compare the performance of a new oxygen delivery device, the OxyArm (OA) (Southmedic Inc, Canada), with a standard nasal cannula (NC) (Salter-Style 1600, Salter Labs, USA) for both oxygen delivery and patient preference in patients on long-term oxygen therapy (LTOT). DESIGN AND SETTING: Randomized crossover study conducted in an outpatient setting. PATIENTS AND METHODS: Twenty-five clinically stable LTOT patients were randomly assigned to an oxygen device (NC or OA) sequence. The baseline saturation level was determined, and patients were then treated at oxygen flow rates of 2 L/min, 3 L/min, 4 L/min, 5 L/min, 6 L/min and 7 L/min for 10 min each while at rest. Patients were then crossed over to the second device and the procedure was repeated. Oximetry values were then obtained following a 5 min walk test using the same device sequence. Lastly, the patients were sent home for a four-week home OA trial, after which, they filled out a questionnaire. RESULTS: This sample of patients was primarily elderly ex-smokers with severe chronic obstructive pulmonary disease on oxygen therapy for the majority of the day. The primary findings were that the OA and NC were equally effective in delivering oxygen to patients and maintaining their oxygen saturation at both rest (P=0.82) and during a 5 min walk test (P=0.83). A patient's personal experience and comfort were identified as the most important factors in deciding on an oxygen device. Most patients felt that the OA was most suited for oxygen therapy while at rest. CONCLUSIONS: The OA proved to be similar to the NC in delivering oxygen and maintaining saturation in patients on LTOT. The OA is one of the few alternatives to using NCs for these patients and, with its current design, appears to be most suited for resting conditions.

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Predictors of Oxygen Desaturation During Submaximal Exercise in 8,000 Patients

Cited by 97 publications

References 15 publications

3‐Min step test and treadmill exercise for evaluating exercise-induced asthma

3‐Min step test and treadmill exercise for evaluating exercise-induced asthma

Recommendations on the use of exercise testing in clinical practice

Comparison of Nasal Cannulas and the OxyArm in Patients Requiring Chronic Domiciliary Oxygen Therapy

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