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

Abstract

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 (Sp<smlcap>o</smlcap>₂) and diffusion capacity for carbon monoxide (D<smlcap>l</smlcap><smlcap>c</smlcap><smlcap>o</smlcap>) are predictors of EID in chronic obstructive pulmonary disease (COPD). Methods: We measured FEV₁, D<smlcap>l</smlcap><smlcap>c</smlcap><smlcap>o</smlcap>, Sp<smlcap>o</smlcap>₂ at rest and during a 6-min walking test as well as physical activity by an accelerometer. A drop in Sp<smlcap>o</smlcap>₂ 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.

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

“…Severe hypoxemia is relatively uncommon, and long-term administration of oxygen has been shown to increase survival in such patients [5]. Although reports on the prevalence of exertional desaturation without resting hypoxemia in COPD are rare [6,7], some research suggests that exertional desaturation may be a predictor of mortality in these patients with COPD [8,9,10]. …”

Distribution of Bone Mineral Content Is Associated with Body Weight and Exercise Capacity in Patients with Chronic Obstructive Pulmonary Disease

“…Several studies have demonstrated that physical inactivity deteriorates exercise-induced oxygen desaturation [40] and systemic inflammation and results in higher serum levels of interlekin-6 and tumor necrosis factor-α [41,42], which can contribute to osteoporosis [43]. These findings suggest that active patients with higher V·O 2 max levels may have lower levels of these cytokines, resulting in preserved bone mass.…”

Incapacity, Handicap, and Oxidative Stress Markers of Male Smokers With and Without COPD

“…Oxygen desaturation during a 6MWT provides information regarding exercise-induced desaturation, disease severity, and disease progress. 8 Exercise-induced desaturation is associated with impaired daily physical activity, faster FEV 1 decline, and worse prognosis, 50 which supports its clinical importance.…”