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Correspondence |

COPD, Normoxia, and Early Desaturation FREE TO VIEW

Ignacio García-Talavera, MD; Armando Aguirre-Jaime, PhD
Author and Funding Information

Respiratory Department, Research Unit Hospital Universitario Candelaria Tenerife, Spain

Correspondence to: Ignacio García-Talavera, MD, Candelaria Hospital, El Rosario 145, Santa Cruz, Spain 38010; e-mail: igarmark@gobiernodecanarias.org


The authors have no conflicts of interest to disclose.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).


Chest. 2009;135(3):885-886. doi:10.1378/chest.08-2286
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Published online

To the Editor:

I read with utmost interest the article by Drummond et al1 recently published in CHEST (September 2008). After a retrospective analysis, the authors confirm that patients with COPD who are hypoxia free at rest but have desaturation during exercise are at higher risk than those who do not have desaturation in spite of the fact that continuous oxygen therapy is not followed by a significant survival improvement when compared to a group without oxygen therapy. The problem is that the authors do not explain why oxygen therapy was indicated and, what is more important, they did not analyze the desaturation time in the 6-min walking test.

Our recently published article2 showed that only those patients with a time to desaturation of 1 min (early desaturators) also desaturate during the 24-h oximetry. However, late desaturators (patients with a time to desaturation > 3 to 30 min) do not have desaturation during a 24-h oximetry. It could thus very well be that the patients of Drummond et al1 were late desaturators in whom oxygen therapy may not have produced the benefit it provides to early desaturators.

Finally, although Gorecka et al3 did not find any improvement in the survival rate of patients with COPD and moderate hypoxia treated with oxygen therapy, they did not analyze the desaturation during the walking test either. At any rate, the effects of oxygen therapy in patients with COPD, normoxemia at rest, and early desaturation in the 6-min walking test remain to be evaluated.

Drummond MB, Blackford AL, Benditt JO, et al. Continuous oxygen use in nonhypoxemic emphysema patients identifies a high-risk subset of patients. Chest. 2008;134:497-506. [PubMed] [CrossRef]
 
García-Talavera I, Hernández García C, Casanova C, et al. Time to desaturation in the 6-min walking distance test predicts 24-hours oximetry in COPD patients with a Po2between 60 and 70 mm Hg. Respir Med. 2008;102:1026-1032. [PubMed]
 
Gorecka D, Gorzelak K, Sliwinski P, et al. Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxemia. Thorax. 1997;52:674-679. [PubMed]
 

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References

Drummond MB, Blackford AL, Benditt JO, et al. Continuous oxygen use in nonhypoxemic emphysema patients identifies a high-risk subset of patients. Chest. 2008;134:497-506. [PubMed] [CrossRef]
 
García-Talavera I, Hernández García C, Casanova C, et al. Time to desaturation in the 6-min walking distance test predicts 24-hours oximetry in COPD patients with a Po2between 60 and 70 mm Hg. Respir Med. 2008;102:1026-1032. [PubMed]
 
Gorecka D, Gorzelak K, Sliwinski P, et al. Effect of long-term oxygen therapy on survival in patients with chronic obstructive pulmonary disease with moderate hypoxemia. Thorax. 1997;52:674-679. [PubMed]
 
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