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Research ArticleOriginal Contributions

Twenty-Four-Hour Ambulatory Oximetry Monitoring in COPD Patients With Moderate Hypoxemia

Ciro Casanova, Ma Concepción Hernández, Alejandro Sánchez, Ignacio García-Talavera, Juan Pablo de Torres, Juan Abreu, Jose Manuel Valencia, Armando Aguirre-Jaime and Bartolomé R Celli
Respiratory Care December 2006, 51 (12) 1416-1423;
Ciro Casanova
Respiratory Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain;
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  • For correspondence: [email protected]
Ma Concepción Hernández
Pulmonary Department, Hospital Universitario de Canarias, Tenerife, Spain.
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Alejandro Sánchez
Pulmonary Department, Hospital Insular de Canarias, Gran Canaria, Spain.
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Ignacio García-Talavera
Respiratory Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain;
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Juan Pablo de Torres
Respiratory Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain;
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Juan Abreu
Pulmonary Department, Hospital Universitario de Canarias, Tenerife, Spain.
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Jose Manuel Valencia
Pulmonary Department, Hospital Doctor Negrin, Gran Canaria, Spain.
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Armando Aguirre-Jaime
Respiratory Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain;
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Bartolomé R Celli
Pulmonary and Critical Care Department, St Elizabeth's Medical Center, Boston, Massachusetts.
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Abstract

BACKGROUND: The relationship of diurnal desaturations (oximetry-measured blood oxygen saturation [SpO2] < 90%) during activities of daily living and clinical aspects in patients with chronic obstructive pulmonary disease (COPD) and moderate hypoxemia has not been systematically evaluated.

METHODS: We prospectively studied 88 patients with stable COPD (forced expiratory volume in the first second [FEV1] < 80% of predicted, ratio of FEV1 to forced vital capacity < 70% of predicted, and PaO2 60–70 mm Hg) with 24 hours of ambulatory oximetry. Desaturators were defined as those who spent ≥ 30% of the time with SpO2 < 90%. Patients engaged in their usual activities of daily living. We correlated these desaturations with the following variables, measured immediately before the 24 hours of oximetry: body mass index, dyspnea (measured with the modified Medical Research Council dyspnea scale), gas exchange, pulmonary function, quality of life (measured with the Saint George's respiratory questionnaire), and comorbidity (measured with the Charlson index).

RESULTS: Thirty-three (38%) of the patients were desaturators: 50% nocturnal and 22% diurnal. We also measured daytime arterial blood gas values from arterial blood samples and found that the desaturators had higher PaCO2 (p = 0.001) and lower PaO2 (p = 0.007) than the nondesaturators. There were no differences in the other variables. The correlation between nocturnal and diurnal time with SpO2 < 90% was r2 = 0.67, and the concordance was low (Cohen's kappa 0.43, p < 0.001).

CONCLUSIONS: Patients with stable COPD and moderate hypoxemia have frequent and potentially important desaturations during activities of daily living and at night. In addition, there is a big difference in the profile and degree of nocturnal and diurnal desaturations. Twenty-four hours of oximetry provides valuable information for comprehensive evaluation of patients with COPD.

  • chronic obstructive pulmonary disease
  • COPD
  • ambulatory
  • oximetry
  • hypoxemia

Footnotes

  • Correspondence: Ciro Casanova MD, Respiratory Research Institute, Hospital Universitario La, Candelaria, Carretera del Rosario s/n, 38010 Santa Cruz de Tenerife, Spain. E-mail: ccasanova{at}canarias.org.
  • Ciro Casanova MD presented a version of this report at the 99th International Conference of the American Thoracic Society, held May 16-21, 2003, in Seattle, Washington.

  • The authors report no conflicts of interest related to the content of this paper.

  • Copyright © 2006 by Daedalus Enterprises Inc.
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Respiratory Care: 51 (12)
Respiratory Care
Vol. 51, Issue 12
1 Dec 2006
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Twenty-Four-Hour Ambulatory Oximetry Monitoring in COPD Patients With Moderate Hypoxemia
Ciro Casanova, Ma Concepción Hernández, Alejandro Sánchez, Ignacio García-Talavera, Juan Pablo de Torres, Juan Abreu, Jose Manuel Valencia, Armando Aguirre-Jaime, Bartolomé R Celli
Respiratory Care Dec 2006, 51 (12) 1416-1423;

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Twenty-Four-Hour Ambulatory Oximetry Monitoring in COPD Patients With Moderate Hypoxemia
Ciro Casanova, Ma Concepción Hernández, Alejandro Sánchez, Ignacio García-Talavera, Juan Pablo de Torres, Juan Abreu, Jose Manuel Valencia, Armando Aguirre-Jaime, Bartolomé R Celli
Respiratory Care Dec 2006, 51 (12) 1416-1423;
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Keywords

  • chronic obstructive pulmonary disease
  • COPD
  • ambulatory
  • oximetry
  • hypoxemia

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