Oxygen
Therapy Research
Oxygen
Therapy & COPD
BACKGROUND:
In patients with COPD, oxygen therapy has been shown to improve
exercise capacity and survival. Increase in barometric pressure at low
altitude can serve as a simple way to improve arterial oxygenation in
hypoxemic patients. We have tried to evaluate the effect of staying at
low altitude on arterial oxygenation and exercise performance in
patients with COPD.
PATIENTS AND METHOD:
Eleven patients with COPD (9 male, 2 female) aged
38 to 79 years (mean FEV1, 0.96 L; 36% predicted) with hypoxemia (mean
PaO2, 54.2+/-8.9 mm Hg) at Jerusalem (altitude 800 m above sea level)
were taken down to the Dead Sea area (altitude 402 m below sea level)
for 3 weeks. At both locations we tested arterial blood gases,
spirometry, progressive exercise, 6-minute walking distance, and sleep
oximetry. The study was repeated 2 weeks after returning to Jerusalem.
RESULTS:
Spirometry results were unchanged. Mean arterial PaO2 rose
from 54.2+/-8.9 mm Hg to 69.5+/-11 at the first week and to 66.6+/-11
at the third week of stay (p<0.001). PaCO2 rose from 43.5+/-9.8 mm
Hg to 47.7+/-9 and 49.5+/-8.4 (p<0.006). Six-minute walking
distance rose from 337+/-107 m to 449+/-73 and 507+/-91 in the third
week (p<0.005). Maximum oxygen consumption (VO2max) rose from
901+/-257 mL/min to 1,099+/-255 and 1,063+/-250 mL/min (p=0.01). Sleep
oximetry showed an increase in mean sleep arterial oxygen saturation
from 86.0+/-4.3% to 89.9+/-4.2% and 88.3+/-3.0 at 1 and 3 weeks,
respectively (p<0.05). Following the return to Jerusalem, arterial
gases returned to their baseline levels (PaO2, 52.9+/-9.4 mm Hg) but
6-min walking distance remained significantly high, 453+/-47
(p<0.02), and VO2max remained high as well (1,102+/-357 mL/min),
although it did not reach statistical significance.
CONCLUSIONS:
Decline to low altitude or staving at high oxygen
environment improves arterial oxygenation and exercise capacity in
hypoxemic patients residing in moderate or high altitude. Low altitude
(or pressurized wards) can improve pulmonary rehabilitation of
hypoxemic patients with COPD.
Kramer MR, Springer C,
Berkman N, Glazer M, Bublil M, Bar-Yishay E, Godfrey S, Pulmonary
Institute, Hadassah University Hospital, Ein Kerem, Hebrew University,
Jerusalem, Israel., Chest 1998 Mar;113(3):571-5
return to top
|
|
