Factors predicting exercise-induced oxygen desaturation in stable COPD

Hussein, Khaled; Alkarn, A; Elsokkary, Raafat; Hamdy, Samiaa; Shams, Hamdy

doi:10.1016/j.ejcdt.2013.02.009

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…Hussein et al 27 include 55 patients in a study where they were divided into desaturators and nondesaturators on the basis of SpO 2 during CPET and found out that in desaturators FEV 1 %, DLCO% and baseline SpO 2 were significantly lower, while PaCO 2 , mPAP and mMRC scores were significantly higher. Dogra et al 28 test 60 COPD patients and report a high risk (55%) of desaturation during 6MWT.…”

Section: Resultsmentioning

confidence: 99%

Desaturation during Physical Exercise in COPD Patients – a Stable-over-time Phenomenon

Kalinov¹,

Marinov²,

Stoyanova³

et al. 2019

Folia Medica

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Introduction: Exercise-induced desaturation is a common finding in patients with moderate and severe COPD. It is an important marker in the course of disease that has a prognostic value for mortality risk. Aim: To monitor over time COPD patients with and without desaturation during 6-minute walking test (6MWT) and to assess the stability of that phenomenon. Materials and methods: A 6MWT was administered to 70 patients with COPD which ranged in severity from stage 2A to stage 4D (GOLD 2011); the patients had a mean age of 64.5±10.1, mean pack-years - 38.8±21, FEV1% = 46.4%±15.7%, FVC% = 73.7%±1.3%, MRC = 2.31±0.84, CAT = 20.8±6.6. Oxygen saturation was monitored during the test; indications for desaturation were a decrease of SpO2 by ≥4% and a fall in SpO2 to ≤88% for at least 3 min. The patients were followed-up for mean 40.9±22.3 months and tests were repeated. Results: Patients were divided into two groups based on the decrease in SpO2: Group A included patients with desaturation (n=35) and Group B – patients with no desaturation (n=35). In 66 of the patients the desaturation profile was stable over time. Only two patients, who did not desaturated at baseline, experienced desaturation in the follow-up 6MWT and another two patients, who desaturated at baseline, did not have it later in the follow-up. Conclusion: Desaturation is a phenomenon that is persistent over time. Based on the results, it could be concluded that exercise-induced desaturation is a major marker of a particular COPD phenotype.

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Section: Resultsmentioning

confidence: 99%

Desaturation during Physical Exercise in COPD Patients – a Stable-over-time Phenomenon

Kalinov¹,

Marinov²,

Stoyanova³

et al. 2019

Folia Medica

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“…Andrianopoulos et al [ 27 ] found on a multivariate model that DLCO <50%, FEV 1 <45%, PaO 2 <10 kPa, baseline-SpO 2 <95%, and female sex were the strongest determinants of EID. Baseline oxygen saturation of SpO 2 ≤95% solely was inaccurate to predict EID occurrence among COPD patients but a combination of clinical characteristics increases the odds for EID in COPD.…”

Section: Discussionmentioning

confidence: 99%

Exercise-induced desaturation in patients with chronic obstructive pulmonary disease on six-minute walk test

et al. 2015

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Background and Objectives:Exercise-induced desaturation (EID) is associated with increased mortality in chronic obstructive pulmonary disease (COPD). However, the relationship of EID with anthropometric and clinical parameters of resting pulmonary function test and six-minute walk test (6MWT) in COPD remains unclear. The study was designed to assess the correlate of EID and to identify various possible predictors of EID in stable normoxemic patients of COPD.Materials and Methods:Sixty patients with stable COPD diagnosed and staged as per the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underwent 6MWT. A drop in standard pulse oximetry (SpO2) of ≥4% or nadir up to ≤88% was defined as EID. Based on EID during 6MWT, two groups were formed: desaturators (DS) and nondesaturators (NDS). DS and NDS were compared for baseline and clinical characters by the Student's t-test while Pearson and Spearman rho correlation coefficient assessed strength of the association of anthropometric and clinical variables with EID. The predictors of EID were identified by logistic regression and receiver operator curve analysis.Result:Out of 60 patients with stable COPD, 33 patients desaturated on exercise (n = 33/60). DS had significantly lower values of FEV1 (P < 0.001), FVC (P < 0.01) FEV1/FVC (P < 0.01) compared to NDS. EID had significant negative correlation with FEV1 (r = 0.31, P < 0.01), resting oxygen saturation (r = 0.549, P < 0.001) and 6MWD (r = 0.511, P < 0.001). Resting SpO2 ≤93% was found to a predictor of EID with a sensitivity and specificity of 83% and 78%, respectively.Interpretation and Conclusion:The 6MWT is a safe and sensitive test to recognize EID in normoxic stable COPD patients. Resting oxygen saturation is a good predictor of EID.

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“…A walk test is not always practical. Data from one small study in COPD suggest that MRC scores may help predict the likelihood of exercise desaturation 52. From this it appears that patients with COPD, MRC score 1 or 2 and resting oxygen saturations >95% do not usually need further testing before air travel.…”

Section: Methodsmentioning

confidence: 99%