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Abstract
BACKGROUND: Continuous monitoring of pulse oximetry (SpO2) is recommended during the 6-min walk test (6MWT) to ensure that the lowest SpO2 is recorded. In this case, severe exercise-induced desaturation (EID; SpO2 < 80%) triggers walking interruption by the examiner. Our main objective was to assess the impact of this approach on 6MWT distance in patients with chronic respiratory diseases and, second, to evaluate the safety of the test without interruption due to severe EID.
METHODS: 6MWTs with continuous monitoring of SpO2 were prospectively performed in subjects with chronic respiratory disease. The participants were randomly allocated to walk with or without SpO2 real-time assessment. SpO2 visualization during the test execution was available only in the first group, and walking interruption was requested by the examiner if SpO2 < 80%.
RESULTS: One hundred forty-five participants were included in each group (68.6% females, 62 [52–69] y old) without differences in demographic and resting lung function parameters between them. The main respiratory conditions were COPD (n = 101), asthma (n = 73), pulmonary hypertension (n = 47), and interstitial lung disease (n = 39). The walked distance was similar comparing groups (349.5 ± 117.5 m vs 351.2 ± 105.4 m). Twenty-five subjects presented with severe EID in the group with real-time SpO2 assessment, and 20 subjects had severe EID in the group without real-time assessment respectively (overall prevalence of 15.5%). The 23 participants who had their test interrupted by the examiner due to severe EID in the first group (2 subjects stopped by themselves due to excessive symptoms) walked a shorter distance compared to the 11 subjects with severe EID without test interruption in the second group (9 subjects stopped by themselves due to excessive symptoms): 240.6 ± 100.2 m versus 345.9 ± 73.4 m. No exercise-related serious adverse events were observed.
CONCLUSIONS: Interruption driven by severe EID reduced the walked distance during the 6MWT. No serious adverse event, in turn, was observed in subjects with severe desaturation without real-time SpO2 assessment.
- 6-min walk test
- oximetry
- pulmonary disease
- chronic obstructive
- asthma
- interstitial lung diseases
- hypertension
- pulmonary
Footnotes
- Correspondence: Danilo C Berton, Rua Ramiro Barcelos, 2350, Sala 2050, CEP 90035–003, Porto Alegre, RS, Brasil. E-mail: dberton{at}hcpa.edu.br
Brazilian Registry of Clinical Trials number: RBR-9qss9jn.
The authors have disclosed no conflicts of interest.
Dr de Azevedo presented preliminary data contained in this manuscript at the European Respiratory Society Congress, held in Barcelona, September 4–6, 2022.
This study was supported by Fundo de Incentivo a Pesquisa do Hospital de Clínicas de Porto Alegre, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, and Conselho Nacional de Desenvolvimento Científico e Tecnológico.
Supplementary material related to this paper is available at http://www.rcjournal.com.
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