Oxygen transport and oxygen consumption during supplemental oxygen administration in patients with chronic obstructive pulmonary disease

Corriveau, Michael L.; Rosen, Barbara J.; Dolan, Gerald F.

doi:10.1016/s0002-9343(89)80395-x

Cited by 22 publications

(18 citation statements)

References 9 publications

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“…Only at rest the oxygen consumption was slightly increased in Fi02 0.35 which may be interpreted as a small oxygen debt in the case of breathing room air. This is consistent with the results of Corriveau et al [2] in COPD patients receiving 26% oxygen mixture.…”

Section: Discussionsupporting

confidence: 93%

“…The results of the study of Bye et al [5], who showed that a delay of respiratory muscle fatigue occurs in oxygen breathing COPD patients at exercise, do not seem to play a major role in respect to peak ventilation. The limited ventilatory capacity in COPD could not be changed by oxygen treatment either in ours or previous studies [2][3][4][5][6][7]. However, our results show conclusively that the effects of oxygen breathing on ventilation occur at submaximum exercise by lowering the minute ventilation in the corresponding steps of work load.…”

Section: Discussioncontrasting

confidence: 48%

“…Many authors have reported studies on exercise hypox emia [2,7] and on the effects of oxygen administration using different methods of measurement (mass spectrom eters, closed systems). We sought to evaluate effects of adequate oxygen administration (FiCT 0.35) on exercise capacity in exertional hypoxemic COPD patients by a noninvasive, open system and on-line measurement of gas exchange, ventilation and oxygen saturation to gain insight into the oxygen-dependent mechanisms of exer cise limitation.…”

Section: Introductionmentioning

confidence: 99%

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Exercise Hypoxemia and the Effects of Increased Inspiratory Oxygen Concentration in Severe Chronic Obstructive Pulmonary Disease

Mitlehner¹,

Kerb²

1994

Respiration

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Exercise-associated oxygen desaturation in severe chronic obstructive pulmonary disease (COPD) remains a topic of unknown prognostic and clinical relevance and of unknown therapeutic importance. Furthermore, exercise limitation in these patients is due to multifactorial interaction of respiratory, cardiac, circulatory and ‘peripheral’ mechanisms. For the evaluation of the role of the oxygen-dependent mechanisms of exercise limitation we studied 14 stable patients with severe COPD (FEV₁ 32% pred., FEV₁/VC 41%, thoracic gas volume of 180% pred.) and mean Pa O₂64 mm Hg by a stage 1 cycle exercise test during breathing room air (FiO₂ 0.21) and hyperoxic (FiO₂ 0.35) air. The measurements were performed by an open system using a low dead space valve (55 ml) measuring real-time breath by breath oxygen consumption (VO₂) via a differential oxygen sensor, expired carbon dioxide (VCO₂), ventilation (VE), oxygen pulse and oxygen saturation in both conditions. With FiO₂ 0.21 the mean exercise limitation was restricted to 37 ( ± 14) W and the VO₂ to 11.7 ( ± 2.4) ml/kg/min with peak oxygen desaturation of 86.4 ( ± 3.2). With FiO₂ 0.35 the patients achieved a significant increase of workload to 55 ( ± 12.4) W and of VO₂to 14.9 ( ± 2.9) ml/kg/min. Despite the complete abolition of exercise desaturation by FIO2 0.35 the mean peak ventilation of 261/ min ( ± 5.1) vs. 27 1/min ( ± 4.1) remained unaltered and therefore the restriction of the ventilatory pump limited the exercise ability. The effects of FiO₂0.35 occurred in these patients at submaximum exercise and may be related to reduction of ventilatory cost of energy and delayed onset of metabolic acidosis. We conclude that oxygen treatment in borderline hypoxemic COPD patients who desaturate in exercise is of substantial benefit because oxygen may diminish the generally excessive ventilatory cost of energy at submaximum exercise.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

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Exercise Hypoxemia and the Effects of Increased Inspiratory Oxygen Concentration in Severe Chronic Obstructive Pulmonary Disease

Mitlehner¹,

Kerb²

1994

Respiration

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“…An improvement in cardiac output may occur either by preventing hypoxic inhibition of myocardial contractility or preventing right ventricular dysfunction by reducing hypoxic pulmonary vasoconstriction. These factors have been shown to contribute to the benefits of O 2 therapy during exercise in patients with COPD [38]. Increasing O 2 delivery to the exercising muscles has been shown to result in delayed onset of lactic acidosis [39].…”

Section: Mechanisms Of Improvement In Exercise Durationmentioning

confidence: 99%

The role of supplemental oxygen during submaximal exercise in patients with cystic fibrosis

McKone

Barry²,

FitzGerald³

et al. 2002

Eur Respir J

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Repeated bouts of submaximal exercise are an important part of most pulmonary rehabilitation programmes. Patients with moderate-to-severe cystic fibrosis (CF) often demonstrate oxygen desaturation during submaximal exercise, which may limit their ability to participate in these programmes. This study examines whether arterial desaturation contributes to submaximal exercise limitation by testing whether supplemental O2improves submaximal exercise capacity.Eight patients with CF (mean forced expiratory volume in one second 41% predicted) each underwent two submaximal exercise tests on a bicycle ergometer at 80% of maximal workload. The two tests were identical except for the addition of supplemental O2(inspiratory O2fraction 39%) during one of the tests.Exercise duration was significantly longer in the supplemental O2studyversuscontrol (673±63 sversus835±99 s). Arterial O2saturation was also higher in the supplemental O2study than the control exercise test (96±0.3%versus86±1.5%). There was no statistical difference at end exercise between O2consumption, minute ventilation and heart rate. There was a significant relationship between improvement in exercise capacity and the amount of desaturation during the control exercise test.Results indicate that supplemental oxygen improves submaximal exercise capacity in patients with moderate-to-severe cystic fibrosis. Oxygen therapy may be an important intervention to improve participation and maximise the benefits of pulmonary exercise rehabilitation programmes.

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“…Obviously supplemetnal oxygen to correct systemic arterial oxygen desaturation will augment oxygen delivery through improved hemoglobin oxygen saturation. However, significant improvements in tissue oxygen deliv ery are likely to be mediated through changes in cardiac function [16]. Pulmonary vasoconstriction which responds to oxygen supplementation will allow for a reduction in right ventricular afterload and potentially improve right ventricular function.…”

Section: Potential Therapeutic Benefits Of Oxygen Supplementation Of mentioning

confidence: 99%

Is Loss of Body Weight in Chronic Obstructive Pulmonary Disease Patients with Emphysema Secondary to Low Tissue Oxygenation?

Donahoe

Rogers

Cottrell³

1992

Respiration

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The available clinical information to date does not support the hypothesis that tissue oxygen debt is the primary cause of the wasting process in the chronic obstructive pulmonary disease (COPD) patient population. However, this should not deter the ‘believers’ of the hypothesis from further investigation. The information outlined above supports the need for reconsideration of this clinical problem. Tissue oxygen requirements and utilization is a complex interplay of multiple variables. Likewise, the assessment of nutritional status in the setting of oxygen therapy is complicated by shifts in body fluid compartments independent of changes in the fat-free mass (FFM). Utilization of newer techniques will be required to resolve the contribution of low tissue oxygenation to the wasting process. The continued development of noninvasive methods for the assessment of tissue metabolism, cardiac function, and tissue energy requirements will allow investigators to further clarify the relationship between tissue oxygenation and metabolism in patients with COPD. Clinical trials designed to examine this issue must recognize the multiple effects of oxygen on all aspects of nutrient utilization, including caloric intake, needs, and tissue delivery. Failure to address all aspects of this system will lead to continued debate regarding the etiology of weight loss in the COPD patient population.

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Oxygen transport and oxygen consumption during supplemental oxygen administration in patients with chronic obstructive pulmonary disease

Cited by 22 publications

References 9 publications

Exercise Hypoxemia and the Effects of Increased Inspiratory Oxygen Concentration in Severe Chronic Obstructive Pulmonary Disease

Exercise Hypoxemia and the Effects of Increased Inspiratory Oxygen Concentration in Severe Chronic Obstructive Pulmonary Disease

The role of supplemental oxygen during submaximal exercise in patients with cystic fibrosis

Is Loss of Body Weight in Chronic Obstructive Pulmonary Disease Patients with Emphysema Secondary to Low Tissue Oxygenation?

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