Oxygen saturation during daily activities in chronic obstructive pulmonary disease

Patients with chronic obstructive pulmonary disease (COPD) frequently develop nocturnal oxygen desturation because of alveolar hypoventilation, worsening of ventilation-perfusion mismatch, and sometimes obstructive sleep apnoeas. In contrast, little is known about their oxygen status during the various activities of daily life. The aim of this study was to compare the oxygen saturation profile during day and night, and to assess the influence of different daily activities in COPD. During a rehabilitation programme, we studied 30 patients with moderate-to-severe COPD (median forced expiratory volume in one second (FEV1) 37% of predicted), without marked hypoxaemia (median arterial oxygen tension (Pa,O2) 9.1 kPa). Arterial oxygen saturation (Sa,O2) was assessed by pulse oximetry during night (8 h) and day (10.5 h). The mean and minimal Sa,O2 were calculated, and desaturations were defined as Sa,O2 falls > 4%.h-1. Daily activities were identified by the patients as resting, eating, washing, nebulization therapy and walking. Mean Sa,O2 was lower during the night (88%) than during the day (89%). In contrast, minimal Sa,O2 was lower during the day (69%) than during the night (72%), and the number of desaturations was higher during the day (8.6 desaturations.h-1) than during the night (6.8 desaturations.h-1). Mean Sa,O2 was 88% during walking, which was lower than during resting (90%), nebulization (90%), and meals (89%). The number of desaturations was higher during walking (13.1 desaturations.h-1), washing (12.6 desaturations.h-1), and eating (9.2 desaturations.h-1) than during resting (5.3 desaturations.h-1). We conclude that daily activities, such as walking, washing and eating, are associated with transient oxygen desaturation in patients with moderate-to-severe chronic obstructive pulmonary disease, even without marked resting hypoxaemia.

This article has been cited by other articles:

				K Jatta, G Eliason, G M Portela-Gomes, L Grimelius, O Caro, L Nilholm, A Sirjso, K Piehl-Aulin, and S M Abdel-Halim Overexpression of von Hippel-Lindau protein in skeletal muscles of patients with chronic obstructive pulmonary disease J. Clin. Pathol., January 1, 2009; 62(1): 70 - 76. [Abstract] [Full Text] [PDF]

				S. Radom-Aizik, N. Kaminski, S. Hayek, H. Halkin, D. M. Cooper, and I. Ben-Dov Effects of exercise training on quadriceps muscle gene expression in chronic obstructive pulmonary disease J Appl Physiol, May 1, 2007; 102(5): 1976 - 1984. [Abstract] [Full Text] [PDF]

				M. Dreher, J. H. Storre, and W. Windisch Noninvasive ventilation during walking in patients with severe COPD: a randomised cross-over trial Eur. Respir. J., May 1, 2007; 29(5): 930 - 936. [Abstract] [Full Text] [PDF]

				F. Pitta, T. Troosters, M. A. Spruit, V. S. Probst, M. Decramer, and R. Gosselink Characteristics of Physical Activities in Daily Life in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., May 1, 2005; 171(9): 972 - 977. [Abstract] [Full Text] [PDF]

				M. Delmastro, C. Santoro, and S. Nava Respiratory changes during defecation in patients with chronic respiratory failure Eur. Respir. J., April 1, 2004; 23(4): 617 - 619. [Abstract] [Full Text] [PDF]

				R.T. Jagoe and M.P.K.J. Engelen Muscle wasting and changes in muscle protein metabolism in chronic obstructive pulmonary disease Eur. Respir. J., November 2, 2003; 22(46_suppl): 52s - 63s. [Abstract] [Full Text] [PDF]

				A. M Yohannes and M. J Connolly Early mobilization with walking aids following hospital admission with acute exacerbation of chronic obstructive pulmonary disease Clinical Rehabilitation, May 1, 2003; 17(5): 465 - 471. [Abstract] [PDF]

				D A Raeside, A Brown, K R Patel, D Welsh, and A J Peacock Ambulatory pulmonary artery pressure monitoring during sleep and exercise in normal individuals and patients with COPD Thorax, December 1, 2002; 57(12): 1050 - 1053. [Abstract] [Full Text] [PDF]

				T. Eaton, J.E. Garrett, P. Young, W. Fergusson, J. Kolbe, S. Rudkin, and K. Whyte Ambulatory oxygen improves quality of life of COPD patients: a randomised controlled study Eur. Respir. J., August 1, 2002; 20(2): 306 - 312. [Abstract] [Full Text] [PDF]

				British Thoracic Society Standards of Care Subcomm Pulmonary rehabilitation Thorax, November 1, 2001; 56(11): 827 - 834. [Full Text] [PDF]

				E. C. Jolly, V. Di Boscio, L. Aguirre, C. M. Luna, S. Berensztein, and R. J. Gene Effects of Supplemental Oxygen During Activity in Patients With Advanced COPD Without Severe Resting Hypoxemia Chest, August 1, 2001; 120(2): 437 - 443. [Abstract] [Full Text] [PDF]

				G. H. GUYATT, D. A. McKIM, B. WEAVER, P. A. AUSTIN, R. E. J. BRYAN, S. D. WALTER, M. L. NONOYAMA, I. M. FERREIRA, and R. S. GOLDSTEIN Development and Testing of Formal Protocols for Oxygen Prescribing Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 942 - 946. [Abstract] [Full Text]

				M. Cutaia New Insights Into the Temporal Pattern of Hypoxemia in COPD Chest, December 1, 2000; 118(6): 1521 - 1522. [Full Text] [PDF]

				R Garrod, E A Paul, and J A Wedzicha Supplemental oxygen during pulmonary rehabilitation in patients with COPD with exercise hypoxaemia Thorax, July 1, 2000; 55(7): 539 - 543. [Abstract] [Full Text]

				M. P. K. J. ENGELEN, A. M. W. J. SCHOLS, J. D. DOES, N. E. P. DEUTZ, and E. F. M. WOUTERS Altered Glutamate Metabolism Is Associated with Reduced Muscle Glutathione Levels in Patients with Emphysema Am. J. Respir. Crit. Care Med., January 1, 2000; 161(1): 98 - 103. [Abstract] [Full Text]

				J. Pilling and M. Cutaia Ambulatory Oximetry Monitoring in Patients With Severe COPD: A Preliminary Study Chest, August 1, 1999; 116(2): 314 - 321. [Abstract] [Full Text] [PDF]