scholarly journals Effort Oxygen Saturation and Effort Heart Rate to Detect Exacerbations of Chronic Obstructive Pulmonary Disease or Congestive Heart Failure

2019 ◽  
Vol 8 (1) ◽  
pp. 42 ◽  
Author(s):  
César Gálvez-Barrón ◽  
Felipe Villar-Álvarez ◽  
Jesús Ribas ◽  
Francesc Formiga ◽  
David Chivite ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Pulmonary Disease ◽  
Physiological Parameters ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The Mean

Background: current algorithms for the detection of heart failure (HF) and chronic obstructive pulmonary disease (COPD) exacerbations have poor performance. Methods: this study was designed as a prospective longitudinal trial. Physiological parameters were evaluated at rest and effort (walking) in patients who were in the exacerbation or stable phases of HF or COPD. Parameters with relevant discriminatory power (sensitivity (Sn) or specificity (Sp) ≥ 80%, and Youden index ≥ 0.2) were integrated into diagnostic algorithms. Results: the study included 127 patients (COPD: 56, HF: 54, both: 17). The best algorithm for COPD included: oxygen saturation (SaO2) decrease ≥ 2% in minutes 1 to 3 of effort, end-of-effort heart rate (HR) increase ≥ 10 beats/min and walking distance decrease ≥ 35 m (presence of one criterion showed Sn: 0.90 (95%, CI(confidence interval): 0.75–0.97), Sp: 0.89 (95%, CI: 0.72–0.96), and area under the curve (AUC): 0.92 (95%, CI: 0.85–0.995)); and for HF: SaO2 decrease ≥ 2% in the mean-of-effort, HR increase ≥ 10 beats/min in the mean-of-effort, and walking distance decrease ≥ 40 m (presence of one criterion showed Sn: 0.85 (95%, CI: 0.69–0.93), Sp: 0.75 (95%, CI: 0.57–0.87) and AUC 0.84 (95%, CI: 0.74–0.94)). Conclusions: effort situations improve the validity of physiological parameters for detection of HF and COPD exacerbation episodes.

scholarly journals Using a Virtual Game System to Innovate Pulmonary Rehabilitation: Safety, Adherence and Enjoyment in Severe Chronic Obstructive Pulmonary Disease

2013 ◽  
Vol 20 (5) ◽  
pp. 357-361 ◽  
Author(s):  
Rima Wardini ◽  
Esther Dajczman ◽  
Nathan Yang ◽  
Marcel Baltzan ◽  
David Préfontaine ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Upper Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patient Reported ◽  
Virtual Game

OBJECTIVE: The present pilot study tested the use of a virtual game system (VGS) for exercise training in patients with moderate to very severe chronic obstructive pulmonary disease undergoing pulmonary rehabilitation (PR). Safety, feasibility, enjoyment and adherence were assessed.METHODS: VGS (Wii [2006], Nintendo, USA) games were prescreened and categorized into lower- and upper-body workouts. Patients admitted for a three- to four-week inpatient PR program exercised daily. They were provided an opportunity to individually engage in VGS sessions three times weekly, varying with length of stay. Dyspnea, oxygen saturation and heart rate were measured before, during and after game sessions. Patients were considered to be adherent if they attended at least 50% of VGS sessions. Adverse events and enjoyment were evaluated.RESULTS: Thirty-two patients with a mean (± SD) age of 66±9 years and a mean forced expiratory volume in 1 s of 0.72±0.40 L participated. Among the 25 patients completing the program, adherence was 76%, with a mean attendance rate of 64±35%. Mean dyspnea score was 1.5±1.1 before and 3.2±1.2 after exercise. Mean oxygen saturation changed from 94±3% to 91±5% (P<0.001), while heart rate increased from 88±15 beats/min to 102±18 beats/min (P<0.001). One patient reported chest pain requiring nitroglycerin spray and five experienced transient desaturation below 85% with play. Patients enjoyed the program (visual analogue score 8±2.6/10) and most would highly recommend it to others.CONCLUSIONS: Moderate exercise using a VGS was safe, feasible and enjoyed as an adjunct to inpatient PR. This modality may encourage patients to maintain physical activity after PR.

scholarly journals Once Daily Versus Overnight and Symptom Versus Physiological Monitoring to Detect Exacerbations of Chronic Obstructive Pulmonary Disease: Pilot Randomized Controlled Trial

10.2196/17597 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e17597
Author(s):  
Ahmed M Al Rajeh ◽  
Yousef Saad Aldabayan ◽  
Abdulelah Aldhahir ◽  
Elisha Pickett ◽  
Shumonta Quaderi ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Once Daily ◽  
Copd Exacerbations ◽  
Daily Monitoring ◽  
The Mean

Background Earlier detection of chronic obstructive pulmonary disease (COPD) exacerbations may facilitate more rapid treatment with reduced risk of hospitalization. Changes in pulse oximetry may permit early detection of exacerbations. We hypothesized that overnight pulse oximetry would be superior to once-daily monitoring for the early detection of exacerbations. Objective This study aims to evaluate whether measuring changes in heart rate and oxygen saturation overnight is superior to once-daily monitoring of both parameters and to assess symptom changes in facilitating earlier detection of COPD exacerbations. Methods A total of 83 patients with COPD were randomized to once-daily or overnight pulse oximetry. Both groups completed the COPD assessment test questionnaire daily. The baseline mean and SD for each pulse oximetry variable were calculated from 14 days of stable monitoring. Changes in exacerbation were expressed as Z scores from this baseline. Results The mean age of the patients was 70.6 (SD 8.1) years, 52% (43/83) were female, and the mean FEV1 was 53.0% (SD 18.5%) predicted. Of the 83 patients, 27 experienced an exacerbation. Symptoms were significantly elevated above baseline from 5 days before to 12 days after treatment initiation. Day-to-day variation in pulse oximetry during the stable state was significantly less in the overnight group than in the once-daily group. There were greater relative changes at exacerbation in heart rate than oxygen saturation. An overnight composite score of change in heart rate and oxygen saturation changed significantly from 7 days before initiation of treatment for exacerbation and had a positive predictive value for exacerbation of 91.2%. However, this was not statistically better than examining changes in symptoms alone. Conclusions Overnight pulse oximetry permits earlier detection of COPD exacerbations compared with once-daily monitoring. Monitoring physiological variables was not superior to monitoring symptoms, and the latter would be a simpler approach, except where there is a need for objective verification of exacerbations. Trial Registration ClinicalTrials.gov NCT03003702; https://clinicaltrials.gov/ct2/show/NCT03003702

scholarly journals Heart rate variability in patients with chronic heart failure and chronic obstructive pulmonary disease: clinical parallels

2016 ◽  
Vol 97 (3) ◽  
pp. 421-425 ◽  
Author(s):  
V M Gazizianova ◽  
O V Bulashova ◽  
E V Khazova ◽  
A A Nasybullina ◽  
M I Malkova
Keyword(s):  
Heart Failure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Congestive Heart Failure ◽  
Heart Rate Variability ◽  
Pulmonary Disease ◽  
Practical Importance ◽  
Integrative Approach ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Diseases comorbidity issues are of concern of many researchers, in recent decades, there are attempts to understand the hierarchy of diseases cause-and-effect relationships. Integrative approach to the patient’s condition assessment, whose comorbidity index increases with aging, is of great practical importance, since it allows the practitioner to choose the best drug therapy strategy and to objectively assess the risk of adverse cardiovascular events. Cardiovascular diseases, including those associated with bronchopulmonary system diseases, occupy leading position in mortality rate. One of the most common combinations in clinical practice is a combination of heart failure and chronic obstructive pulmonary disease. Their pathogenetic relationship may be due to common for diseases neurohumoral imbalance. The review presents data on the prevalence and mortality of patients with congestive heart failure and chronic obstructive pulmonary disease, describes the importance of autonomic nervous system dysfunction assessment in cardiovascular and bronchopulmonary diseases combination. Data on the heart rate variability assessment informativeness from the perspective of the clinical characteristics determination relevance and prognosis in patients with congestive heart failure and chronic obstructive pulmonary disease are presented. The main assessed time-domain and spectral parameters are narrated. The results of the heart rate variability parameters study in multicenter clinical trials in patients groups with heart failure and bronchopulmonary obstruction, which define the clinical and prognostic predictors among the heart rate variability parameters, are presented. In general, information on heart rate variability in congestive heart failure in comorbidity with chronic obstructive pulmonary disease is scantily presented in the available literature.

scholarly journals Utilization of Chronic Obstructive Pulmonary Disease Assessment Test (CAT) in Patients with COPD in Low Resource Countries

2019 ◽  
pp. 1-7
Author(s):  
Akor, Alexander Agada ◽  
Obaseki Daniel ◽  
Bamidele Adeniyi ◽  
Gregory Efosa Erhabor
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Walking Distance ◽  
Disease Assessment ◽  
Chronic Obstructive ◽  
Respiratory Disorder ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Low Resource ◽  
The Mean

Background: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disorder commonly assessed by spirometry and health related quality of life (HRQoL) questionnaires. COPD assessment test (CAT) is a new questionnaire used for HRQoL evaluation especially in a clinic setting. Aims: To assess HRQoL using the CAT, and to determine the relationship of CAT to other measures of COPD such as pulmonary function test (PFT), dyspnea and six minutes walking distance test (6MDWT) among patients with COPD in Nigeria. Settings and Design: Cross-sectional study.                  Methods: Sixty stable patients with a clinical and spirometric diagnosis of COPD according to the GOLD criteria were recruited into the study. Spirometry was performed according to ATS/ERS guidelines. Health status, dyspnea and functional capacity of the patients were assessed using the CAT questionnaire, modified medical research council (MMRC) dyspnea scale and six-minute walking distance (6MDWT) respectively. Results: The mean age was 68.8 years ± 10.3. Sixty percent of the study participants were male. The mean BMI was 21.6 ± 4.8 kg/m2, 37(61.7%) of the patients were ex-smokers, 3.3% were current smokers and 35% were never smokers. In terms of frequency of exacerbations 18.3% had ≤ 1 per year and 5.0% had ≥ 2 per year. The CAT was strongly associated with 6MWDT (r = 0.85P < 0.001), FEV1% predicted (r= 0.67, P< 0.001) and with MMRC (r=0.64, p<0.01). Conclusions: CAT scores correlated well with percent FEV1, dyspnea and exercise tolerance which measures various aspect of COPD. It may serve as an easy to administer sensitive tool in assessing stable COPD in outpatient clinics especially in low resource countries.

scholarly journals Once Daily Versus Overnight and Symptom Versus Physiological Monitoring to Detect Exacerbations of Chronic Obstructive Pulmonary Disease: Pilot Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Ahmed M Al Rajeh ◽  
Yousef Saad Aldabayan ◽  
Abdulelah Aldhahir ◽  
Elisha Pickett ◽  
Shumonta Quaderi ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Once Daily ◽  
Copd Exacerbations ◽  
Daily Monitoring ◽  
The Mean

BACKGROUND Earlier detection of chronic obstructive pulmonary disease (COPD) exacerbations may facilitate more rapid treatment with reduced risk of hospitalization. Changes in pulse oximetry may permit early detection of exacerbations. We hypothesized that overnight pulse oximetry would be superior to once-daily monitoring for the early detection of exacerbations. OBJECTIVE This study aims to evaluate whether measuring changes in heart rate and oxygen saturation overnight is superior to once-daily monitoring of both parameters and to assess symptom changes in facilitating earlier detection of COPD exacerbations. METHODS A total of 83 patients with COPD were randomized to once-daily or overnight pulse oximetry. Both groups completed the COPD assessment test questionnaire daily. The baseline mean and SD for each pulse oximetry variable were calculated from 14 days of stable monitoring. Changes in exacerbation were expressed as Z scores from this baseline. RESULTS The mean age of the patients was 70.6 (SD 8.1) years, 52% (43/83) were female, and the mean FEV1 was 53.0% (SD 18.5%) predicted. Of the 83 patients, 27 experienced an exacerbation. Symptoms were significantly elevated above baseline from 5 days before to 12 days after treatment initiation. Day-to-day variation in pulse oximetry during the stable state was significantly less in the overnight group than in the once-daily group. There were greater relative changes at exacerbation in heart rate than oxygen saturation. An overnight composite score of change in heart rate and oxygen saturation changed significantly from 7 days before initiation of treatment for exacerbation and had a positive predictive value for exacerbation of 91.2%. However, this was not statistically better than examining changes in symptoms alone. CONCLUSIONS Overnight pulse oximetry permits earlier detection of COPD exacerbations compared with once-daily monitoring. Monitoring physiological variables was not superior to monitoring symptoms, and the latter would be a simpler approach, except where there is a need for objective verification of exacerbations. CLINICALTRIAL ClinicalTrials.gov NCT03003702; https://clinicaltrials.gov/ct2/show/NCT03003702

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