Exercise response to oxygen supplementation is not associated with survival in hypoxemic patients with obstructive lung disease
File(s)
Author(s)
Sadaka, AS
Montgomery, AJ
Mourad, SM
Polkey, MI
Hopkinson, NS
Type
Journal Article
Abstract
Purpose: Hypoxemia is associated with more severe lung disease and worse outcomes. In some patients with chronic obstructive lung diseases who desaturate on exertion, supplemental oxygen improves exercise capacity. The clinical significance of this exercise response to oxygen supplementation is not known.
Patient and methods: We identified chronic obstructive lung disease patients at our center who underwent a six-minute walking test (6MWT) for ambulatory oxygen assessment and who desaturated breathing air and therefore had an additional walk test on supplemental oxygen, between August 2006 and June 2016. Responders were defined as walking >26m further with oxygen. Survival was determined up to 1st February 2017. We compared survival in oxygen responders and non-responders in patients with obstructive lung diseases.
Results: 174 patients were included in the study, median age 70 years. 77(44.3%) of the patients were oxygen responders. Borg dyspnea score improved by 1.4(±1.4) units (P<0.0005) on oxygen. Median survival was 66 months with death occurring in 84(48.2%) patients. Kaplan-Meier analysis revealed no survival difference between both responders and non-responders (P=0.571). Cox regression analysis showed that more 6MWT desaturation, lower 6MWD on room air, male gender, lower hemoglobin and BMI were associated with higher mortality risk.
Conclusion: Acute exercise response to supplemental oxygen is not associated with long-term survival in patients with obstructive lung disease. This supports the use of ambulatory oxygen treatment for symptomatic purposes only.
Patient and methods: We identified chronic obstructive lung disease patients at our center who underwent a six-minute walking test (6MWT) for ambulatory oxygen assessment and who desaturated breathing air and therefore had an additional walk test on supplemental oxygen, between August 2006 and June 2016. Responders were defined as walking >26m further with oxygen. Survival was determined up to 1st February 2017. We compared survival in oxygen responders and non-responders in patients with obstructive lung diseases.
Results: 174 patients were included in the study, median age 70 years. 77(44.3%) of the patients were oxygen responders. Borg dyspnea score improved by 1.4(±1.4) units (P<0.0005) on oxygen. Median survival was 66 months with death occurring in 84(48.2%) patients. Kaplan-Meier analysis revealed no survival difference between both responders and non-responders (P=0.571). Cox regression analysis showed that more 6MWT desaturation, lower 6MWD on room air, male gender, lower hemoglobin and BMI were associated with higher mortality risk.
Conclusion: Acute exercise response to supplemental oxygen is not associated with long-term survival in patients with obstructive lung disease. This supports the use of ambulatory oxygen treatment for symptomatic purposes only.
Date Issued
2018-05-17
Date Acceptance
2018-03-19
Citation
International Journal of COPD, 2018, 13, pp.1607-1612
ISSN
1176-9106
Publisher
Dove Medical Press
Start Page
1607
End Page
1612
Journal / Book Title
International Journal of COPD
Volume
13
Copyright Statement
© 2018 Sadaka et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
Subjects
Science & Technology
Life Sciences & Biomedicine
Respiratory System
6-minute walking test
exercise
hypoxemia
obstructive lung disease
oxygen
6-MIN WALK TEST
AIR-FLOW OBSTRUCTION
PULMONARY-DISEASE
COPD PATIENTS
NUTRITIONAL-STATUS
MORTALITY
DESATURATION
PREDICTOR
DISTANCE
RISK
1102 Cardiovascular Medicine And Haematology
Publication Status
Published