Chest
Clinical InvestigationsCOPDIncidence of Nocturnal Desaturation While Breathing Oxygen in COPD Patients Undergoing Long-term Oxygen Therapy
Section snippets
Materials and Methods
We studied 82 consecutive COPD patients (54 men and 28 women; mean age, 60.2 ± 8.2 years) who were eligible for LTOT. Diagnosis of COPD was established based on commonly accepted criteria.3, 4 Indications for LTOT were stable hypoxemia, defined as (1) Pao2 < 55 mm Hg, or (2) Pao2 between 55 and 59 mm Hg if hypoxemia coexisted with one of the following signs: signs of pulmonary hypertension on chest radiograph (15 patients), signs of right ventricle hypertrophy on ECG (16 patients), or elevated
Results
As expected, all patients desaturated during the night while breathing air, and the T90 was 90% (Table 2 ). While breathing oxygen, the mean overnight Sao2 in the group as a whole was satisfactory (90.9 ± 5.0%). However, we found that many patients spent an important part of the night in desaturation (Sao2 < 90%). Using a cutoff point of a T90 of > 30%,7 we divided the study group into “nondesaturators” (43 subjects, 52.4%) and“ desaturators” (39 subjects, 47.6%). Functional characteristics and
Discussion
We found that almost half of COPD patients eligible for LTOT desaturated during sleep despite breathing oxygen at an airflow ensuring good oxygenation at rest and while awake. To our best knowledge, our study is the first to assess the incidence of nocturnal desaturation in such a large nonselected group of COPD patients. Previous observations were based on much smaller groups.
As early as 1977, Flick and Block11 first reported nocturnal desaturations in COPD patients receiving oxygen. Of 10
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2015, Medical HypothesesCitation Excerpt :The prevalence of patients with COPD who are normoxic while awake and who spend at least 30% of the total sleep time (TST) with a mean pulsed oxygen saturation (SpO2) below 90% ranges from 38% to 70% [17–19]. Based on the same criteria, it is also notable that nocturnal desaturation in COPD is observed in approximately half of the patients undergoing long-term oxygen therapy because the diurnal flow rate is often insufficient to prevent nocturnal desaturation [75]. However, it is quite difficult to determine the percentage of patients with COPD who desaturate during the NREM sleep stages because all the studies to date have considered the total sleep time, thus including REM sleep.
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