Chest
Clinical InvestigationsCOPDAcute Effects of Hyperoxia on Dyspnea in Hypoxemia Patients With Chronic Airway Obstruction at Rest
Section snippets
Patients
The study was performed on 10 male patients with severe CAO receiving long-term oxygen. Nine patients had COPD, and one patient had bronchiectasis (Table 1). Diagnosis was made according to American Thoracic Society (ATS) guidelines.13 One patient with COPD (patient 7) had chronic pleural effusion. The patients were clinically and functionally stable at the time of the study, ie, absence of exacerbation and significant changes in spirometry during the preceding 4 weeks. No patients received
Results
All patients had severe obstructive pulmonary disease characterized by FEV1 < 42% predicted and FEV1/FVC < 54% (Table 1). In patient 5, who had bronchiectasis, the TLC was below the normal limits, a common feature in this disease, though the increased body weight (body mass index of 31) probably also contributed to his restrictive pattern. Only one patient (patient 10) was a responder to bronchodilation (ΔFEV1 = 21% of control) according to ATS but not European Respiratory Society criteria.
Discussion
The results of this study indicate that in patients with CAO receiving long-term domiciliary oxygen for severe hypoxemia, hyperoxic breathing at rest induces a significant reduction of ventilation and DH with concurrent improvement of dyspnea sensation.
References (30)
- et al.
Oxygen relieves breathlessness in “pink puffers.”
Lancet
(1981) Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease
Ann Intern Med
(1980)- et al.
Early effects of oxygen administration and prognosis in chronic obstructive pulmonary disease and cor pulmonale
Am Rev Respir Dis
(1983) - et al.
Relationship between ventilation and breathlessness during exercise in chronic obstructive airways disease is not altered by prevention of hypoxaemia
Clin Sci
(1984) - et al.
Supplemental oxygen and exercise ability in chronic obstructive airways disease
Thorax
(1988) - et al.
The effect of nasal flow on breathlessness in patients with chronic obstructive pulmonary disease
Am Rev Respir Dis
(1988) - et al.
Symptomatic benefit of supplemental oxygen in hypoxemic patients with chronic lung disease
Am Rev Respir Dis
(1991) Intrinsic PEEP
- et al.
Force reserve of the diaphragm in patients with chronic obstructive pulmonary disease
J Appl Physiol
(1983) - et al.
Relationship between chronic dyspnea and expiratory flow limitation in COPD patients
Am J Respir Crit Care Med
(1996)
Occlusion pressure as a measure of respiratory center output in conscious man
Respir Physiol
Effect of salbutamol on dynamic hyperinflation in chronic obstructive pulmonary disease patients
Eur Respir J
Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma
Am Rev Respir Dis
Lung function testing: selection of reference values and interpretative strategies
Am Rev Respir Dis
Multiple breath helium dilution measurement of lung volumes in adults
Eur Respir J
Cited by (19)
Clinically important differences in the intensity of chronic refractory breathlessness
2013, Journal of Pain and Symptom ManagementCitation Excerpt :The terms “small,” “moderate” and “large” are relative to each other and will be different for individuals and perhaps also within subpopulations and should be taken into consideration when interpreting results. This is illustrated by data from a total of 95 participants from five studies in people with chronic obstructive pulmonary disease in which a VAS was used as the outcome measurement,18 three studies of pulmonary rehabilitation,19–21 and one each in oxygen supplementation22 and lung reduction surgery.23 Ries18 found effect sizes ranging between 0.48 (11.9 mm) and 1.76 (30.3 mm) equating to moderate-to-large improvements.
Pharmacological treatment of hyperinflation
2009, Revue des Maladies RespiratoiresThe effects of high-flow vs low-flow oxygen on exercise in advanced obstructive airways disease
2004, ChestCitation Excerpt :Oxygen has been shown to improve exercise tolerance in a dose-dependent fashion,12 and O'Donnell and colleagues13 reported similar findings in a double-blind crossover study in patients with severe COPD exercising on 60% Fio2 vs room air. The reduction in dyspnea and ventilation has been also shown to occur at rest with hyperoxia,14 a finding that was not duplicated in this study because our patients were never hypoxemic during the protocol. This improvement in exercise capacity and reduced dyspnea with hyperoxia has been attributed to a decrease in ventilatory demands, decrease in dynamic end-expiratory volumes, and alteration in respiratory muscle recruitment.131516
Oxygen
2014, Dyspnea: Mechanisms, Measurement, and Management, Third EditionGeneral redox environment and carotid body chemoreceptor function
2009, American Journal of Physiology - Cell Physiology
This work was performed at Service de Réanimation Médicale et Assistance Respiratoire, Hôpital de la Croix-Rousse, Lyon, France.