Nocturnal Hypoxaemia in Chronic Obstructive Pulmonary Disease

1983 ◽  
Vol 64 (2) ◽  
pp. 213-222 ◽  
Author(s):  
J. R. Stradling ◽  
D. J. Lane
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen Tension ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Strongly Correlated ◽  
Obstructive Pulmonary Disease ◽  
Nocturnal Hypoxaemia ◽  
Oxygen Difference

1. Day and night arterial oxygen saturation (Sao2) has been measured in forty-one patients with chronic obstructive pulmonary disease (COPD), mean FEV1 0.84 (range 0.4-1.4) litres, and with a range of daytime Sao2 values of 67-95%. 2. The mean and biggest falls in Sao2 at night were much greater in the patients with lower daytime saturations. However, when falls in arterial oxygen tension (Pao2) were estimated from the decreases in Sao2, there was no correlation between the estimated biggest fall in Pao2 and daytime Sao2 and only a weak correlation between estimated mean fall in Pao2 and daytime Sao2. 3. Measurement of ventilation in four hypoxaemic patients with COPD (range 60-90% Sao2) by respiratory inductance plethysmography showed that nocturnal hypoxaemic dips were accompanied by diminished ventilation, which was not always shown by nasal thermistors. 4. Because nocturnal hypoxaemic dips are transient the ideal alveolar-arterial oxygen difference, which assumes a constant respiratory exchange ratio, cannot be used to assess the mechanism of hypoxaemia. 5. Erythrocyte mass was strongly correlated with daytime Sao2 but this correlation was not significantly improved by including nocturnal hypoxaemia in the regression. 6. The results suggest that greater falls in Sao2 at night are related to lower initial Sao2 values and that the cause-5-be a reduction in ventilation.

scholarly journals Meal Induced Oxygen Desaturation and Dyspnea in Chronic Obstructive Pulmonary Disease

1998 ◽  
Vol 5 (5) ◽  
pp. 361-365 ◽  
Author(s):  
Norman Wolkove ◽  
Li Yi Fu ◽  
Ashok Purohit ◽  
Antoinette Colacone ◽  
Harvey Kreisman
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Arterial Oxygen Saturation ◽  
Care Facility ◽  
Forced Expiratory Volume ◽  
Oxygen Desaturation ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Copd

OBJECTIVE: To study arterial oxygen saturation (SpO2) obtained by pulse oximetry and dyspnea during active eating (AE) and passive eating (PE) in patients with severe chronic obstructive pulmonary disease (COPD).DESIGN: Patients were studied on two consecutive days with AE and PE, which occurred in random order. SpO2was recorded for 20 mins before and during eating, and dyspnea was recorded by the patient using a 10 cm visual analogue scale before and upon completion of eating.SETTING: Subjects were in-patients at an intermediate care facility who were hospitalized for pulmonary rehabilitation or for convalescence after an exacerbation of COPD.POPULATION STUDIED: Thirty-five patients with severe COPD (forced expiratory volume in 1 s [FEV1] less than 50% predicted, FEV1to forced vital capacity ratio less than 65%) were studied. Mean age was 70.5±7.1 years.MAIN RESULTS: Mean SpO2decreased significantly (P<0.05) from 91.7±3.4% to 90.1±4.0% during AE, and 91.7±3.2% to 90.8±3.6% during PE. Mean lowest SpO2was lower and percentage of time with SpO2less than 90% was greater during eating compared with corresponding control periods during both AE and PE. Dyspnea increased significantly (P<0.05) from 1.4±1.2 to 3.3±2.3 cm during AE, and from 1.5±1.5 to 2.4±2.2 cm during PE. The increase in dyspnea was significantly greater during AE than PE.CONCLUSIONS: Eating is an activity that can adversely affect SpO2and increase dyspnea in patients with severe COPD. Oxygen desaturation and particularly increased dyspnea may at least in part relate to the recruitment of upper extremity muscles during eating.

Nocturnal desaturation and serum erythropoietin: A study in patients with chronic obstructive pulmonary disease and in normal subjects

1993 ◽  
Vol 84 (3) ◽  
pp. 319-324 ◽  
Author(s):  
Michael F. Fitzpatrick ◽  
Tom MacKay ◽  
Kenneth F. Whyte ◽  
Martin Allen ◽  
Robert C. Tam ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oxygen Saturation ◽  
Pulmonary Disease ◽  
Arterial Oxygen Saturation ◽  
Normal Subjects ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Serum Erythropoietin Level ◽  
Serum Erythropoietin

1. To clarify the relationship between nocturnal oxygen desaturation and erythropoietin production in patients with chronic obstructive pulmonary disease, we determined arterial oxygen saturation and serum immunoreactive erythropoietin levels over 24 h in eight patients with chronic obstructive pulmonary disease and in nine normal subjects. 2. In the normal subjects, there was a significant circadian variation in serum erythropoietin levels with the highest mean deviation from the geometric mean at 22.00 hours and the nadir at 05.00 hours. 3. The three patients with chronic obstructive pulmonary disease with the most marked nocturnal desaturation (lowest arterial oxygen saturation <57%) and most marked daytime hypoxaemia (daytime arterial partial pressure of oxygen < 6 kPa) had raised nocturnal serum erythropoietin levels. In two of these patients, the serum erythropoietin level was raised throughout the 24 h and erythrocyte mass was also raised. In the other patient, the serum erythropoietin level was not raised in five daytime samples and erythrocyte mass was normal. 4. The other five patients with chronic obstructive pulmonary disease with less severe nocturnal hypoxaemia (lowest arterial oxygen saturation range 78–86%) had serum erythropoietin levels (range 14–36 m-i.u./ml) which were indistinguishable from normal (range 12–44 m-i.u./ml) and showed circadian changes which were not significantly different (P = 0.35) from those in the normal subjects. 5. Thus, mild nocturnal oxygen desaturation is not associated with elevation of serum erythropoietin levels, whereas daytime hypoxaemia with associated severe nocturnal desaturation is associated with increased serum erythropoietin levels both by day and by night.

Effect of Fenspiride on Pulmonary Function in the Rat and Guinea Pig

1995 ◽  
Vol 88 (3) ◽  
pp. 325-330 ◽  
Author(s):  
D. Bee ◽  
E. A. Laude ◽  
C. J. Emery ◽  
P. Howard
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Arterial Oxygen Tension ◽  
Whole Body ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood ◽  
Airways Resistance ◽  
Anti Inflammatory

1. Fenspiride is an anti-inflammatory agent that may have a role in reversible obstructive airways disease. Small, but significant, improvements have been seen in airways function and arterial oxygen tension in patients with mild chronic obstructive pulmonary disease. These changes have been attributed to the anti-inflammatory properties of the drug. However, airways function can be improved by other means, e.g. improved ventilation/perfusion ratio or reduced airways resistance. The possibility that fenspiride may have actions other than anti-inflammatory was investigated in two animal species. 2. In the rat, actions on the pulmonary circulation were investigated in the isolated perfused lung, but fenspiride proved to be a poor pulmonary vasodilator, showing only a small reversal of the raised pulmonary artery pressure induced by hypoxia. 3. Ventilation was measured in the anaesthetized rat using whole-body plethysmography. Fenspiride caused no increase in ventilation or changes in arterial blood gases. However, a profound hypotensive action was observed with high doses. 4. The possibility that a decrease in airways resistance (Raw) might occur with fenspiride was investigated in anaesthetized guinea pigs. Capsaicin (30 μmol/l) was used to increase baseline Raw through bronchoconstriction. Fenspiride gave a dose-dependent partial reversal of the raised Raw, and its administration by aerosol proved as efficacious as the intravenous route. In addition, the hypotensive side-effect found with intravenous injection was alleviated by aerosolized fenspiride. 5. An anti-bronchoconstrictor action of fenspiride could be one of the mechanisms involved in improving airways function and Pao2, seen in mild chronic obstructive pulmonary disease.

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