Exertional desaturation in patients with chronic obstructive pulmonary disease

COPD
Ralph J Panos, William Eschenbacher

Abstract

Although the Centers for Medicare and Medicaid Services oxygen prescription guidelines utilize a threshold arterial oxygen tension <or=55 mmHg or an oxygen saturation <or=88%, a range of oxygen levels and relative declines have been used in investigations of exertional desaturation in patients with chronic obstructive pulmonary disease (COPD). There is no uniform definition of exertional hypoxemia or standardized exercise protocol to elicit decreases in oxygen levels in individuals with COPD. The causes for exertional desaturation in patients with COPD are multifactorial with ventilation-perfusion mismatching, diffusion-type limitation, shunting and reduced oxygen content of mixed venous blood all contributing to some degree. Neither resting oxygen saturation nor pulmonary function studies can reliably predict which patients with COPD will develop exertional desaturation. However, preserved pulmonary function, especially diffusing capacity, reliably predicts which patients with COPD will sustain oxygenation during exercise. Although exertional desaturation in patients with COPD appears to portend a poor prognosis, there is no evidence that maintenance of normoxemia during exercise improves the survival of these patients. Studie...Continue Reading

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Citations

Oct 15, 2013·Respiratory Physiology & Neurobiology·Vasileios AndrianopoulosMartijn A Spruit
Mar 30, 2012·Home Healthcare Nurse·John W KayserGaston Ostiguy
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Oct 31, 2020·International Journal of Chronic Obstructive Pulmonary Disease·Chiung-Hsin ChangChih-Hao Chang
Nov 14, 2020·American Journal of Respiratory and Critical Care Medicine·Susan S JacobsAnne E Holland

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