Clinical characteristics of COPD patients with early-onset desaturation in the 6-minute walk test

García‐Talavera, Ignacio; Figueira‐Gonçalves, Juan Marco; Gurbani, Nikita; Pérez‐Méndez, Lina; Pedrero-García, A J

doi:10.1016/j.pulmoe.2018.04.007

Cited by 12 publications

(10 citation statements)

References 15 publications

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“…Desaturation present in 6-minute walk test has been found to be a significant predictor of nocturnal desaturation. This is in concordance with the studies by Garcia-Talavera et al 16 and Moreira et al 17 where 6 minute walk test is found to be an important indicator of nocturnal desaturation and prognosis in COPD. Similar to other studies.…”

Section: Discussionsupporting

confidence: 93%

Predictors of Nocturnal Oxygen Desaturation in Normoxemic Patients with Moderate to Very Severe Chronic Obstructive Pulmonary Disease.

R¹,

P²

2019

IJCMR

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Introduction: COPD is associated with complications such as reduced oxygen saturation and hypoventilation during sleep and is underdiagnosed among normoxemic patients. To identify the daytime parameters to predict nocturnal oxygen desaturation in normoxemic patients with moderate to very severe chronic obstructive pulmonary disease. To correlate the presence of nocturnal oxygen desaturation with pulmonary hypertension. Material and methods: A cross-sectional study was performed at ACS medical college Chennai for 14 months from May 2017 to June 2018. The study population included 103 participants. Data on variables such as 6-minute walk test, spirometry, nocturnal oximetry, partial pressures of O2 and CO2 were assessed. Results: A total of 103 patients were included in the analysis with 93.2% males and 3.9% current smokers and 87.4% ex-smokers. 52.4% had a normal chest X-ray. Around 45.6% had hyperinflated lungs. In the 6 minutes-walktest, 32% participants had desaturation. 50.5% had positive C-reactive protein levels indicating the presence of systemic inflammation. Right atrial/right ventricular dilatation was noted among 34% participants. Nocturnal desaturation with 3 to 4 episodes/hour was present among 39% participants. Univariate analysis results show that post FEV 1, partial pressure of oxygen and carbon dioxide, presence of desaturation and RA/RV dilatation on echocardiography were all statistically significant predictors of nocturnal oxygen desaturation in normoxemic patients with moderate to very severe Chronic Obstructive Lung Disease. Conclusion: Screening the COPD patients for these daytime predictors will enable in identifying the patients who have nocturnal desaturation. This in turn will aid in early initiation of home oxygen therapy.

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Section: Discussionsupporting

confidence: 93%

Predictors of Nocturnal Oxygen Desaturation in Normoxemic Patients with Moderate to Very Severe Chronic Obstructive Pulmonary Disease.

R¹,

P²

2019

IJCMR

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“…The definition of hypoxemia on exercise vary widely. The most used criteria include a nadir arterial oxygen saturation (SpO2) ≤88% [15][16][17][18] and a decrease in SpO2 ≥4% with or without a nadir SpO2<90% [19,23]. In unselected groups of patients with ILD, 49-54% experience exertional hypoxaemia [24,25].…”

Section: Hypoxemia In Ildmentioning

confidence: 99%

Physiological predictors of exertional oxygen desaturation in patients with fibrotic interstitial lung disease

et al. 2019

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the two variables into a "DeOX" score (0-2), we have created a prediction model of desaturation on 6MWT where the presence of one or both variables (DLCO ≤40% and/or SpO2 ≤95%) strongly increased the risk of desaturation in both cohorts separately and in all patients (for both cohort: OR: 8.1 (95%CI: 4.14-15.88) for score 1; OR: 24.8 (95%CI 11.78-57.04) for score 2). Conclusions:We propose a novel scoring system for the risk of oxygen desaturation during 6MWT in patients with ILD, using a combination of two physiological variables, widely available in clinical practice.

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“…Oxygen desaturation is believed to be the result of an imbalance between ventilation and perfusion during physical exercise; the chronic limitation of airflow and the lung's elastic recoil ability result in air becoming trapped and a dynamic hyperinflation phenomenon which increases breathing work and oxygen consumption in patients with COPD . In the study by García‐Talavera et al, they observed that both an initial reduced SatO 2 and low DLCO values (defined as SatO 2 ≤ 93% and DLCO ≤ 55%, respectively) were factors associated with early desaturation in the 6MWT (a drop in SatO 2 equal to or greater than 4% in the first minute of the test). However, in said study, obesity (defined as BMI ≥ 30) was the factor most closely related to the presence of early desaturation as well as the repercussions of said event, which was also shown in the ECLIPSE cohort …”

Section: Discussionmentioning

confidence: 99%

Prognostic ability of the distance‐saturation product in the 6‐minute walk test in patients with chronic obstructive pulmonary disease

Gurbani

Gonçálves

Bello

et al. 2020

Clinical Respiratory J

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Introduction The product (DSP) of the distance walked (meters) and minimum oxygen saturation obtained during the 6‐minute walk test (6MWT) has been proposed as a predictor of mortality in idiopathic pulmonary fibrosis and in bronchiectasis not related to cystic fibrosis. Objective The aim of this study was to determine the DSP's ability to predict mortality in patients with chronic obstructive pulmonary disease (COPD) at the outpatient level and compare it to the BODE index and meters walked in the 6MWT. Material and methods Descriptive observational study in a cohort of patients with COPD being treated at outpatient pulmonology clinics. Each of the patients completed the 6MWT following ATS/ERS protocols and their BODE index and DSP were calculated. Results About 103 patients were included. The average length of follow‐up was 36 months. Patients who died showed a lower number of meters walked in the 6MWT (P < 0.001), as well as a lower DSP (P < 0.001). A 6MWT < 334 m, a DSP < 290 and a BODE ≥ 4 showed good prognostic ability at 3 years (AUC 71%, 69% and 70.4%, respectively). The 6MWT was superior to the BODE index in predicting mortality during the first year of follow‐up (P = 0.023). We did not find any differences between DSP and meters walked in the 6MWT. Conclusions The DSP is a good predictor of mortality, although it does not offer a better prognostic ability than that of meters walked in the 6MWT.

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Clinical characteristics of COPD patients with early-onset desaturation in the 6-minute walk test

Abstract: Overweight and obesity, as determined by body mass index, seem to behave like markers for early desaturation. This simple anthropometric measure might indicate point to potential early desaturation in COPD patients.

Cited by 12 publications

References 15 publications

Predictors of Nocturnal Oxygen Desaturation in Normoxemic Patients with Moderate to Very Severe Chronic Obstructive Pulmonary Disease.

Predictors of Nocturnal Oxygen Desaturation in Normoxemic Patients with Moderate to Very Severe Chronic Obstructive Pulmonary Disease.

Physiological predictors of exertional oxygen desaturation in patients with fibrotic interstitial lung disease

Prognostic ability of the distance‐saturation product in the 6‐minute walk test in patients with chronic obstructive pulmonary disease

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