0
Clinical Investigations: COPD |

Effects of Supplemental Oxygen During Activity in Patients With Advanced COPD Without Severe Resting Hypoxemia*

Enrique C. Jolly, MD; Valentina Di Boscio, MD, FCCP; Laura Aguirre, MD; Carlos M. Luna, MD, FCCP; Sara Berensztein, MD; Ricardo J. Gené, MD
Author and Funding Information

*From the Division of Pulmonary Diseases (Drs. Jolly, Di Boscio, Aguirre, Luna, and Gené) and Division of Cardiology (Dr. Berensztein), Department of Internal Medicine, Hospital de Clínicas “José de San Martín,” Buenos Aires University, Buenos Aires, Argentina.

Correspondence to: Enrique C. Jolly, MD, Larrea 67–11° “A,” 1030 Buenos Aires, Argentina; e-mail: ejolly@intramed.net.ar



Chest. 2001;120(2):437-443. doi:10.1378/chest.120.2.437
Text Size: A A A
Published online

Study objectives: To assess oxygen desaturation during activities and to evaluate the short-term effects of supplemental O2 use in patients with severe COPD who do not qualify for long-term O2 therapy.

Design: A double-blind, randomized, placebo-controlled trial.

Setting: Outpatients from the pulmonary diseases division of a tertiary-care university hospital.

Patients: Twenty patients with stable COPD with FEV1/FVC ratios of < 50%, FEV1 levels< 55% of the predicted normal value, and Pao2 levels of > 60 mm Hg when resting.

Interventions: Patients were initially evaluated with pulmonary function tests, blood gas analysis, and Doppler echocardiography, and they underwent the following three 6-min walking tests (WTs) in a random sequence: basal WT (BWT); WT while breathing compressed air (CAWT); and WT while breathing O2 (O2WT).

Measurements and results: The distance walked was recorded in meters. Dyspnea was measured by Borg scale measurement before and after the tests, and arterial oxygen saturation measured by pulse oximetry (Spo2) was continuously monitored. Results were analyzed by grouping patients in the following manner: desaturators (DSs) (ie, patients with a drop in Spo2 of at least 5% and < 90% during the WT) vs nondesaturators (NDSs); and O2 responders (ie, patients with an increase of at least 10% in the distance walked and/or a decrease of at least 3 points in Borg index score) vs nonresponders. During the BWT, 11 of 20 patients (55%) were defined as desaturators. During the O2WT, the Spo2 remained at > 90% in every patient. The distance walked increased by 22% (p < 0.02), and dyspnea decreased 36% (p < 0.01) in DS patients. In NDS patients, O2 administration reduced dyspnea by 47% (p < 0.001), but the distance walked did not improve. Responses were markedly different from one patient to another. No significant differences were noticed between the results of the BWT and CAWT in any of the groups. Thirteen O2 responders did not differ from 7 nonresponders either in basal data or in desaturation measure during the BWT, except that all walking responders (five patients) were above the median of basal left ventricle performance.

Conclusions: Most of the studied COPD patients desaturated during the BWT. O2 administration avoided desaturation and could increase the distance walked and reduce dyspnea, but these effects were not related to walking desaturation in individual cases. Improvements were not a placebo effect. The therapeutic role of O2 during activities in some patients with severe COPD needs to be individually assessed.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543