Time to Desaturation Less Than One Minute Predicts the Need for Long-Term Home Oxygen Therapy

García‐Talavera, Ignacio; Tauroni, Alfonso; Trujillo, Juan Manuel; Pitti, R.; Eiroa, Luisa; Aguirre‐Jaime, Armando; Sánchez, Alejandro; Abreu, Juan

doi:10.4187/respcare.01164

Cited by 22 publications

(21 citation statements)

References 23 publications

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“…Previous studies ( 19 , 20 ) have shown that the time to desaturation during the 6MWT is an indicator of the possibility of desaturation during activities of daily living, culminating in severe hypoxemia and the need for oxygen therapy. Jenkins & Cecins ( 21 ) analyzed the adverse events that occurred during the 6MWT in a group of 572 patients with COPD who completed the 6MWT; 345 (47%) of the patients experienced significant desaturation (a ≥ 4% decrease).…”

Section: Discussionmentioning

confidence: 99%

“…One group of authors ( 20 ) showed that, of 83 patients with COPD who performed the 6MWT, 48 experienced early desaturation (SpO 2 < 90% before the first minute) and that, over a 5-year follow-up period, 65% of those patients developed severe hypoxemia and required home oxygen therapy, compared with 11% of the patients who did not experience early desaturation (p < 0.001). Early desaturation is also associated with desaturation during a 24-h period and during most activities of daily living.…”

Section: Discussionmentioning

confidence: 99%

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Oxygen desaturation during the six-minute walk test in COPD patients

Moreira¹,

Medeiros²,

Boeno³

et al. 2014

J. bras. pneumol.

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Objective: To evaluate the behavior of oxygen saturation curves throughout the six-minute walk test (6MWT) in patients with COPD. Methods: We included 85 patients, all of whom underwent spirometry and were classified as having moderate COPD (modCOPD, n = 30) or severe COPD (sevCOPD, n = 55). All of the patients performed a 6MWT, in a 27-m corridor with continuous SpO2 and HR monitoring by telemetry. We studied the SpO2 curves in order to determine the time to a 4% decrease in SpO2, the time to the minimum SpO2 (Tmin), and the post-6MWT time to return to the initial SpO2, the last designated recovery time (RT). For each of those curves, we calculated the slope. Results: The mean age in the modCOPD and sevCOPD groups was 66 ± 10 years and 62 ± 11 years, respectively. At baseline, SpO2 was > 94% in all of the patients; none received supplemental oxygen during the 6MWT; and none of the tests were interrupted. The six-minute walk distance did not differ significantly between the groups. The SpO2 values were lowest in the sevCOPD group. There was no difference between the groups regarding RT. In 71% and 63% of the sevCOPD and modCOPD group patients, respectively, a ≥ 4% decrease in SpO2 occurred within the first minute. We found that FEV1% correlated significantly with the ΔSpO2 (r = −0.398; p < 0.001), Tmin (r = −0.449; p < 0.001), and minimum SpO2 (r = 0.356; p < 0.005). Conclusions: In the sevCOPD group, in comparison with the modCOPD group, SpO2 was lower and the Tmin was greater, suggesting a worse prognosis in the former.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Oxygen desaturation during the six-minute walk test in COPD patients

Moreira¹,

Medeiros²,

Boeno³

et al. 2014

J. bras. pneumol.

View full text Add to dashboard Cite

show abstract

“…The availability of nadir Sp O 2 may have led to the identification of more patients with exertional desaturation. Previous reports concerning the time to desaturation during the 6MWT found that early desaturators had a higher probability of desaturation while performing daily activities and of developing severe hypoxemia requiring long-term oxygen therapy [32,33]. Thus more detailed analyses of the clinical course of COPD patients with exertional desaturation might be possible using nadir Sp O 2 and time to desaturation during the 6MWT.…”

Section: Discussionmentioning

confidence: 99%

Exertional Desaturation as a Predictor of Rapid Lung Function Decline in COPD

Kim¹,

Seo²,

Lee³

et al. 2012

Respiration

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Background: To date, no clinical parameter has been associated with the decline in lung function other than emphysema severity in COPD. Objectives: The main purpose of this study was to explore whether the rate of lung function decline differs between COPD patients with and without exertional desaturation. Methods: A total of 224 subjects were selected from the Korean Obstructive Lung Disease cohort. Exertional desaturation was assessed using the 6-min walk test (6MWT), and defined as a post-exercise oxygen saturation (SpO₂) of <90% or a ≥4% decrease. The cohort was divided into desaturator (n = 47) and non-desaturator (n = 177) groups. Results: There was a significant difference between the desaturator and non-desaturator groups in terms of the change in pre-bronchodilator forced expiratory volume in 1 s (FEV₁) over a 3-year period of follow-up (p = 0.006). The mean rate of decline in FEV₁ was greater in the desaturator group (33.8 ml/year) than in the non-desaturator group (11.6 ml/year). A statistically significant difference was also observed between the two groups in terms of the change in the St. George's Respiratory Questionnaire (SGRQ) total score over 3 years (p = 0.001). Conclusions: This study suggests, for the first time, that exertional desaturation may be a predictor of rapid decline in lung function in patients with COPD. The 6MWT may be a useful test to predict a rapid lung function decline in COPD.

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“…These results are concordant with Troosters et al [32], who found that V o 2 (liters/min) showed a plateau after the 3rd min of the 6MWT. The observed fast decline in Sp o 2 in patients with more severe COPD may be of clinical importance as it predicts the need for chronic domiciliary oxygen therapy [33]. At this point it should be mentioned that continuous pulse oximetry is necessary to accurately describe the dynamic changes in Sp o 2 during the 6MWT.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prediction of Exercise-Induced Oxygen Desaturation in Patients with Chronic Obstructive Pulmonary Disease

Gestel¹,

Clarenbach

Stöwhas

et al. 2012

Respiration

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Background: Previous studies with small sample sizes reported contradicting findings as to whether pulmonary function tests can predict exercise-induced oxygen desaturation (EID). Objective: To evaluate whether forced expiratory volume in one second (FEV₁), resting oxygen saturation (Spo₂) and diffusion capacity for carbon monoxide (Dlco) are predictors of EID in chronic obstructive pulmonary disease (COPD). Methods: We measured FEV₁, Dlco, Spo₂ at rest and during a 6-min walking test as well as physical activity by an accelerometer. A drop in Spo₂ of >4 to <90% was defined as EID. To evaluate associations between measures of lung function and EID univariate and multivariate analyses were used and positive/negative predictive values were calculated. Receiver operating characteristic curve analysis was performed to determine the most useful threshold in order to predict/exclude EID. Results: We included 154 patients with COPD (87 females). The mean FEV₁ was 43.0% (19.2) predicted and the prevalence of EID was 61.7%. The only independent predictor of EID was FEV₁ and the optimal cutoff value of FEV₁ was at 50% predicted (area under ROC curve, 0.85; p < 0.001). The positive predictive value of a threshold of FEV₁ <50% was 0.83 with a likelihood ratio of 3.03 and the negative predicting value of a threshold of FEV₁ ≥80% was 1.0. The severity of EID was correlated with daily physical activity (r = –0.31, p = 0.008). Conclusions: EID is highly prevalent among patients with COPD and can be predicted by FEV₁. EID seems to be associated with impaired daily physical activity which supports its clinical importance.

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Time to Desaturation Less Than One Minute Predicts the Need for Long-Term Home Oxygen Therapy

Cited by 22 publications

References 23 publications

Oxygen desaturation during the six-minute walk test in COPD patients

Oxygen desaturation during the six-minute walk test in COPD patients

Exertional Desaturation as a Predictor of Rapid Lung Function Decline in COPD

Prevalence and Prediction of Exercise-Induced Oxygen Desaturation in Patients with Chronic Obstructive Pulmonary Disease

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