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Original Research: COPD |

Monitoring Breathing Rate at Home Allows Early Identification of COPD ExacerbationsEarly Identification of Exacerbations of COPD

Aina M. Yañez, PhD; Dolores Guerrero, MSc; Rigoberto Pérez de Alejo, PhD; Francisco Garcia-Rio, MD; Jose Luis Alvarez-Sala, MD; Miriam Calle-Rubio, MD; Rosa Malo de Molina, MD; Manuel Valle Falcones, MD; Piedad Ussetti, MD; Jaume Sauleda, MD; Enrique Zamora García, MD; Jose Miguel Rodríguez-González-Moro, MD; Mercedes Franco Gay, BSc; Maties Torrent, MD; Alvar Agustí, MD
Author and Funding Information

From the Fundación de Investigación Sanitaria Illes Balears (FISIB) (Dr Yañez and Ms Guerrero), Palma de Mallorca; Airproducts Sud Europa (Dr Pérez de Alejo and Ms Franco Gay), Madrid; Servicio de Neumología (Dr Garcia-Rio), Hospital Universitario La Paz, Instituto de Investigación La Paz (IdiPAZ), Madrid; Servicio de Neumología (Drs Alvarez-Sala and Calle-Rubio), Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid; Hospital Universitario Puerta de Hierro (Drs Malo de Molina, Valle Falcones, and Ussetti) Majadahonda, Madrid; Servei Pneumologia (Dr Sauleda), Hospital Universitari Son Espases, Palma Mallorca; Servicio de Neumología (Dr Zamora García), Hospital de La Princesa, Madrid; Servicio de Neumología (Dr Rodríguez-González-Moro), Hospital Gregorio Marañón, Madrid; Ib-salut (Dr Torrent), Área de Salut de Menorca, Menorca; and the Thorax Institute (Dr Agustí), Hospital Clínic, Institut d’Investigacions Biomediques Agustí Pi i Sunyer (IDIBAPS), Universitat Barcelona, CIBER Enfermedades Respiratorias (CIBERES), and Fundación de Investigación Sanitaria Illes Balears (FISIB) Mallorca, Spain.

Correspondence to: Aina Yañez, PhD, Fundación de Investigación Sanitaria Illes Balears, Edificio S. Hospital Universitario Son Espases, Carretera de Valldemossa, 79-07010 Palma de Mallorca, Spain; e-mail: aina.yanez@caubet-cimera.es


Funding/Support: This study was supported by Air Products Sud Europa, Madrid, Spain.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(6):1524-1529. doi:10.1378/chest.11-2728
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Background:  Respiratory frequency increases during exacerbations of COPD (ECOPD). We hypothesized that this increase can be detected at home before ECOPD hospitalization.

Methods:  To test this hypothesis, respiratory frequency was monitored at home daily for 3 months in 89 patients with COPD (FEV1, 42.3% ± 14.0%; reference) who were receiving domiciliary oxygen therapy (9.6 ± 4.0 h/d).

Results:  During follow-up, 30 patients (33.7%) required hospitalization because of ECOPD. In 21 of them (70%), mean respiratory frequency increased (vs baseline) during the 5 days that preceded it (from 15.2 ± 4.3/min to 19.1 ± 5.9/min, P < .05). This was not the case in patients without ECOPD (16.1 ± 4.8/min vs 15.9 ± 4.9/min). Receiver operating characteristic analysis showed that 24 h before hospitalization, a mean increase of 4.4/min (30% from baseline) provided the best combination of sensitivity (66%) and specificity (93%) (area under the curve [AUC] = 0.79, P < .05). Two days before hospitalization, a mean increase of 2.3/min (15% change from baseline) was associated with a sensitivity of 72% and a specificity of 77% (AUC = 0.76, P < .05).

Conclusions:  Respiratory frequency can be monitored daily at home in patients with COPD receiving domiciliary oxygen therapy. In these patients, breathing rate increases significantly days before they require hospitalization because of ECOPD. This may offer a window of opportunity for early intervention.

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