Validation of a breath-holding test as a screening test for exercise-induced hypoxemia in chronic respiratory diseases

Abstract

The detection of exercise-induced hypoxemia is important for evaluating disease status in patients with chronic respiratory diseases. The 6-min walk test (6MWT) is useful for detecting exercise-induced hypoxemia. This pilot study aimed to validate the breath-holding test (BHT) as a screening for exercise-induced hypoxemia and compare its utility with that of the 6MWT in patients with chronic respiratory diseases. Fifty-nine patients with chronic respiratory diseases underwent BHTs lasting 10, 15, and 20 s. Percutaneous oxygen saturation (SpO2), pulse rate, and severity of dyspnoea were measured. The participants also underwent a 6MWT, a pulmonary function test, and analysis of arterial blood gas at rest. Multivariate linear regression analysis was performed to identify significant predictors of desaturation in the 6MWT. The minimum SpO2 during the BHT (all durations) and 6MWT were significantly correlated. Receiver operating characteristic analysis revealed the optimal cut-off for predicting SpO2 < 90% during the 6MWT as a minimum SpO2 ≤ 94% during the 15-s BHT. Perceived dyspnoea and maximum pulse rate were significantly lower during the 15-s BHT than during the 6MWT. In the multivariate linear regression analysis, the minimum SpO2 during the 15-s BHT (β, 0.565, p < 0.001) and %DLco (β, 0.255, p < 0.028) were independent predictors of desaturation in the 6MWT. The minimum SpO2 during the 15-s BHT may be a useful measure for screening for exercise-induced hypoxemia in patients with chronic respiratory diseases. The BHT is easier to perform, more readily available, and better tolerated than the 6MWT.

Use of Hypoxic Respiratory Challenge for Differentiating Alzheimer’s Disease and Wild-Type Mice Non-Invasively: A Diffuse Optical Spectroscopy Study

“…In this study, the average SpO 2 changed from 98.6% to 94.4% as the supplied gas was changed from 50% O 2 gas balanced by N 2 gas to 16% O 2 gas balanced by N 2 gas. While the drop of SpO 2 in this study was smaller (98.6% → 94.4%: 4.2% difference) than the one of the previous study (97% → 91%: 6% difference) [ 28 ], the drop of SpO 2 , which is observed in a human study during breath-holding [ 63 ], guarantees that the protocol used in this study can mimic breath-holding as well. At the same time, 94.4% SpO 2 can assure the safety of the animal because this value is higher than the one (92% SpO 2 ) of people living in Aspen, Colorado where people do not have any critical health issues [ 28 ].…”

Sleep Apnea and Physical Movement During Sleep, But Not Sleep Duration, Are Independently Associated With Progression of Left Ventricular Diastolic Dysfunction: Prospective Hyogo Sleep Cardio‐Autonomic Atherosclerosis Cohort Study

“…Percutaneous oxygen saturation was also recorded using a pulse oximeter (SAS‐2100, Nihon Kohden,Tokyo, Japan, supplier: Teijin, Tokyo, Japan). 24 The sampling frequency of oxygen saturation was 2 Hz. The following cases were excluded from the measurement as artifact, when the decrease was 3% or more per second, or the sensor was disconnected.…”

CRD Editor’s corner archive: April-June 2021

“…Given how easy it is to do, it is surprizing that the measurement of our ability to hold our breath is not in regular use in the assessment of respiratory disease. Ideguchi and colleagues 7 address this in the journal this month, testing whether desaturation during breath holding relates to exercise desaturation in people with chronic lung disease. They found that the minimum saturation during a 15 s breath hold related well to desaturation during the 6MWT.…”