Acute effect of oxygen therapy on exercise tolerance and dyspnea perception in ILD patients

Ambulatory oxygen therapy (AOT) is commonly prescribed in Interstitial Lung Disease (ILD) patients, with the aim of reducing dyspnea and increasing exercise tolerance. Despite its frequent use and a reasonable physiological rationale, there is a lack of evidence supporting the effect of AOT on improving dyspnea during exercise. Moreover, dyspnea encompasses distinct sensory (intensity, quality) and affective (anxiety, fear) components with different underlying neurophysiological mechanisms. The aim of this study was to evaluate the effect of oxygen supplementation on exercise tolerance and dyspnea in ILD patients with exercise induced hypoxia (EIH). Forty-seven ILD patients performed a six minute walk test (6MWT) on room air (RA) and with oxygen supplementation (Ox). The 6MWT distance (6MWD) was significantly greater with oxygen supplementation (RA: 242±143 m vs Ox: 345±106 m p<0,01). With oxygen supplementation, the overall dyspnea and anxiety significantly decreased both at rest (1,1±1,4 Borg Unit (BU) vs 0,4±0,9BU , p.<0.01, and 1,1±1,6BU vs 0,5±1,3 BU, p.<0.05, respectively) and at the end of exercise (5,1±2,6 BU vs 3,7±2,5 BU, p.<0.001 and 3,4 ±2,9 vs 2,5 ±2,8, p.<0.01, respectively) despite a greater walked distance. In ILD patients with EIH, oxygen supplementation increases the exercise tolerance and reduces overall dyspnea perception and the anxiety component of breathlessness.

Download Full-text

Effect of Oxygen Treatment on Heart Rate after Abdominal Surgery

Anesthesiology ◽

10.1097/00000542-199902000-00008 ◽

1999 ◽

Vol 90 (2) ◽

pp. 380-384 ◽

Cited By ~ 27

Author(s):

Susan Rosenberg-Adamsen ◽

Claus Lie ◽

Anne Bernhard ◽

Henrik Kehlet ◽

Jacob Rosenberg

Keyword(s):

Heart Rate ◽

Abdominal Surgery ◽

Oxygen Saturation ◽

Oxygen Therapy ◽

Arterial Oxygen Saturation ◽

Arterial Oxygen ◽

Cardiac Complications ◽

Oxygen Supplementation ◽

Unselected Group ◽

Effect Of Oxygen

Background Cardiac complications are common during the postoperative period and may be associated with hypoxemia and tachycardia. Preliminary studies in high-risk patients after operation have shown a possible beneficial effect of oxygen therapy on arterial oxygen saturation and heart rate. Methods The authors studied the effect of oxygen therapy on arterial oxygen saturation and heart rate in 100 consecutive unselected patients randomly and double blindly allocated to receive air or oxygen therapy between the first and fourth day after major abdominal surgery. Results The median arterial oxygen saturation rate increased significantly from 96% to 99% (P < 0.0001) and the heart rate decreased significantly from 85 beats/min to 81 beats/min (P < 0.0001) during oxygen supplementation compared with air administered by a binasal catheter. The greatest decrease in heart rate occurred in patients with the lowest oxygen saturation or the highest heart rate values before oxygen supplementation. Overall, 73% of this unselected group of patients responded with decreased heart rate during supplemental oxygen therapy. No significant differences in changes in heart rate after oxygen supplementation were found between patients with or without an epidural catheter or between the postoperative day studied. Conclusion Postoperative oxygen therapy increased arterial oxygen saturation and decreased heart rate after uncomplicated abdominal surgery in a consecutive unselected group of patients who received routine postoperative care.

Download Full-text

Acute Effect of Oxygen on Pulmonary Arterial Pressure Does Not Predict Survival on Long-term Oxygen Therapy in Patients with Chronic Obstructive Pulmonary Disease

American Review of Respiratory Disease ◽

10.1164/ajrccm/146.3.665 ◽

1992 ◽

Vol 146 (3) ◽

pp. 665-669 ◽

Cited By ~ 9

Author(s):

Pawel Śliwiński ◽

Iwona Hawrylkiewicz ◽

Dorota Górecka ◽

Jan Zieliński

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Oxygen Therapy ◽

Pulmonary Arterial Pressure ◽

Acute Effect ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Pulmonary Arterial ◽

Effect Of Oxygen ◽

Long Term Oxygen Therapy

Download Full-text

Methodological Issues of Assessment of Six-minute Walk Test in Patients with Coronary Artery Disease

Journal of restorative medicine and rehabilitation ◽

10.38025/2078-1962-2021-20-3-37-44 ◽

2021 ◽

Vol 20 (3) ◽

pp. 37-44

Author(s):

Tatiana V. Mikhailovskaya ◽

Olga A. Nazarova ◽

Yuriy V. Dovgalyuk ◽

Yulia V. Chistyakova ◽

Irina E. Mishina

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Exercise Tolerance ◽

Walk Test ◽

Risk Of Death ◽

Coronary Syndrome ◽

Six Minute Walk Test ◽

6Mwt Distance ◽

Artery Disease ◽

Minute Walk

The six-minute walk test (6MWT) is an easily performed and well-studied method for assessing exercise tolerance. Despite its availability, there are no standardized approaches to the evaluation of test results in patients with coronary artery disease (CAD). The current review summarizes the evidence and the practical issues of the 6MWT data interpretation in CAD patients. It is recommended by researches to follow current recommendations and protocols of 6MWT in order to achieve high accuracy and reproducibility of the test. The value of the 6MWT distance depends on gender, age, anthropometric and echocardiography parameters. Multiple tests on the same patient cannot be recommended due to the possible development of the “learning effect”. The prognostic value of the 6MWT results was recently established in patients with various diseases. The value of the 6MWT distance ≤ 300 meters in patients with heart failure with a reduced ejection fraction was associated with a significant increase in the risk of death and cardiovascular events; stable results of the 6MWT within one year were associated with a higher survival rate of patients. The concept of the minimally clinically significant difference (MCSD) in the distance of the 6MWT during cardiac rehabilitation of patients was presented. According to the recent data, the MCSD of the 6MWT distance in patients after acute coronary syndrome was 25 meters. The data of our research, the main methods and examples of calculating changes in the 6MWT distance are presented in the article. The results obtained indicate that a comprehensive analysis and simultaneous use of several methods of the 6MWT distance assessment improve the accuracy of rehabilitation results evaluation. Thus, the 6MWT is an affordable way to assess exercise tolerance. It may provide reliable information about changes in the functional capacity of CAD patients in everyday clinical practice.

Download Full-text

ANALYSIS OF EXERCISE TOLERANCE ON THE BASIS OF SIX MINUTE WALK TEST- 6MWT AND BORG- RPE- SCALE IN MEN WITH INGUINAL HERNIA BEFORE AND AFTER LICHTENSTEIN SURGERY

Polish Journal of Surgery ◽

10.5604/01.3001.0014.4207 ◽

2020 ◽

Vol 92 (5) ◽

pp. 1-5

Author(s):

Ewa Machała ◽

Magdalena Redynk ◽

Aneta Gruchała ◽

Krzysztof Kołomecki

Keyword(s):

Inguinal Hernia ◽

Exercise Tolerance ◽

Respiratory Diseases ◽

Significant Negative Correlation ◽

Borg Scale ◽

Six Minute Walk Test ◽

6Mwt Distance ◽

Before And After ◽

And Control ◽

Minute Walk

Assessment of exercise tolerance (ET) plays an important role in qualifications for treatment and rehabilitation. The aim of the study was to assess ET in patients before and after inguinal hernia operations with Lichtenstein method. The cohort study included men with inguinal hernia divided into the study group (SG) (n=50) and control (CG) (n=50) undergone the Lichtenstein surgery. Patients from the SG met the criterion of coexistence of cardiovascular and respiratory diseases. Day before and on the second day after surgery, patients performed 6MWT and subjectively rate the exertion according to Borg- RPE- Scale (before, immediately after and 10 minutes after the test). 6MWT distance, Borg scale ratings were analysed. On the second day after surgery 66% of patients from the SG and 58% from the CG did not complete the test. Patients from the SG before (500,07±40,38 m) and on the second day after surgery (243,46±18,18 m) achieved shorter distances compared to the CG (565,93±20,41 m; 249,47±26,66 m), p<0,001 i p= 0,481. A statistically significant negative correlation between 6MWT distance before surgery and age of the patients was confirmed. Patients who did not develop complications achieved significantly longer distances on admission (p= 0,003 for SG, p=0,004 for CG). For 6MWT before surgery and 2 days after surgery, patients from the SG showed a significantly higher level of fatigue compared to the CG after the test (before: p = 0,001, after: p = 0,001). Patients form the SG often discontinued 6MWT and less tolerated effort compared to the CG. Hence, 6MWT is useful tool for ascertaining physical capacity and ET.

Download Full-text

6-minute walking test in patients after cabg - assessment of exercise capacity

Advances in Rehabilitation ◽

10.1515/rehab-2015-0023 ◽

2015 ◽

Vol 29 (2) ◽

pp. 19-24 ◽

Cited By ~ 1

Author(s):

Joanna Wojtkowska ◽

Izabela Wojtkowska ◽

Jadwiga Wolszakiewicz

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Exercise Tolerance ◽

Disease Risk ◽

Walk Test ◽

6Mwt Distance ◽

Artery Disease ◽

6 Minute Walk Test ◽

Minute Walk

Abstract Introduction: The 6-minute walk test is a well established diagnostic tool in clinical cardiology to determine exercise tolerance, prognostic measure, control and modify the implemented treatment. Aim: Assess exercise tolerance in patients with coronary artery disease after surgical coronary artery bypass grafting using 6-minute walk test in correlation with selected concomitant risk factors for coronary artery disease. Material and methods: Analysis of medical records of 100 randomly selected patients, diagnosed by coronary angiography and coronary heart disease, scheduled for CABG. Patients were evaluated using exercise tolerance as measured by 6MWT before and 12 months after CABG. The results were correlated with the selected risk factors. Results: The study group showed improvement in 6MWT distance of 43.17 m (± 104.41) at 12-months after CABG. In order to analyze which risk factors influenced the observed changes of the 6MWT distance, the obtained results were correlated with factors such as the age of patients, sex, hypertension and smoking. There was no effect of these parameters on shortening or lengthening the distance. Conclusions: 1. From selected coronary artery disease risk factors only hypertension adversely affected the 6MWT distance before CABG. 3. The CABG operation caused significant improvement of exercise tolerance in patients with worse baseline exercise tolerance.

Download Full-text

Prognostic role of results of dynamic capnography in integral assessment of parameters of respiratory system in 6-minute walk test in patients with chronic heart failure

I P Pavlov Russian Medical Biological Herald ◽

10.23888/pavlovj2020283290-299 ◽

2020 ◽

Vol 28 (3) ◽

pp. 290-299

Author(s):

Kira A. Ageeva ◽

Evgenii V. Filippov

Keyword(s):

Respiratory System ◽

Prognostic Significance ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Control Group ◽

Walk Test ◽

Ventricular Ejection Fraction ◽

6Mwt Distance ◽

6 Minute Walk Test ◽

Minute Walk

Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.94.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.63.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р0.05). The distance walked by the patients with CHF in 6 minutes was 488.2390.84 m, which was significantly less than in the control group (815.6053.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.83.0% and 48.05.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.15.0% in the group of CHF and 40.05.0% in the control group, р=0.014), palpitation (29.04.6% and 20.04.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.31.0% of cases (the difference with the control group with р=0.046), the trend of heart rate in 18.80.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.

Download Full-text

Faculty Opinions recommendation of Effect of oxygen supplementation on length of stay for infants hospitalized with acute viral bronchiolitis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.719884138.793500560 ◽

2014 ◽

Author(s):

Venerino Poletti ◽

Claudia Ravaglia

Keyword(s):

Length Of Stay ◽

Oxygen Supplementation ◽

Effect Of Oxygen ◽

Acute Viral Bronchiolitis

Download Full-text

The effectiveness of supplemental oxygen during exercise training in patients with chronic obstructive pulmonary disease who show severe exercise-induced desaturation: a protocol for a meta-regression analysis and systematic review

Systematic Reviews ◽

10.1186/s13643-021-01667-9 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Shohei Kawachi ◽

Shuhei Yamamoto ◽

Kenichi Nishie ◽

Takayoshi Yamaga ◽

Manaka Shibuya ◽

...

Keyword(s):

Systematic Review ◽

Exercise Training ◽

Exercise Tolerance ◽

Supplemental Oxygen ◽

Walking Distance ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Severe Exercise ◽

Meta Regression ◽

Exercise Induced

Abstract Background Supplemental oxygen during exercise training is used to increase the training effect of an exercise program in patients with chronic obstructive pulmonary disease (COPD) who show exercise-induced desaturation. Exercise-induced desaturation is not clearly defined in the guidelines; however, it is generally defined in clinical studies as a decrease in SpO2 of more than 4% from rest or a decrease to less than 88% during exercise. Although some meta-analyses examined the effectiveness of supplemental oxygen during exercise training, these studies concluded that it does not further improve exercise tolerance compared to exercise training alone. However, supplemental oxygen during exercise training may be effective in improving exercise tolerance in COPD patients with severe exercise-induced desaturation. Therefore, this study will be performed to elucidate the effectiveness of supplemental oxygen during exercise training and the relationship between its effectiveness and severity of exercise-induced desaturation at baseline. Methods We will first assess the effectiveness of supplemental oxygen during exercise training in COPD. The main outcome is the change in exercise tolerance before and after the intervention, indicated by the 6-min walking distance, the walking distance, or the walking time in incremental shuttle walking test, and analyzed as the standardized mean difference (SMD). The quality and risk of bias in individual studies will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and risk-of-bias tool (RoB ver.2). If statistical heterogeneity in terms of the effectiveness of exercise tolerance is shown, we will conduct meta-regression analyses to examine the association between the effectiveness of exercise training with supplemental oxygen and severity of exercise-induced desaturation at baseline. Discussion One strength of this study is that it is a systematic review with meta-regression analysis to elucidate the effectiveness of supplemental oxygen during exercise training in patients with COPD who show severe exercise-induced desaturation. Furthermore, we will assess the severity of exercise-induced desaturation for which exercise training with supplemental oxygen is effective, the influence of acute effects at baseline, and the effect of supplemental oxygen on adverse events. Systematic review registration Registration number, UMIN000039960.

Download Full-text

Impact of adherence to long-term oxygen therapy on patients with COPD and exertional hypoxemia followed for one year

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562017000000019 ◽

2018 ◽

Vol 44 (5) ◽

pp. 390-397 ◽

Cited By ~ 2

Author(s):

Carolina Bonfanti Mesquita ◽

Caroline Knaut ◽

Laura Miranda de Oliveira Caram ◽

Renata Ferrari ◽

Silmeia Garcia Zanati Bazan ◽

...

Keyword(s):

Quality Of Life ◽

Oxygen Therapy ◽

Severe Hypoxemia ◽

Bode Index ◽

One Year ◽

Long Term Oxygen Therapy ◽

Minute Walk

ABSTRACT Objective: To determine the impact of adherence to long-term oxygen therapy (LTOT) on quality of life, dyspnea, and exercise capacity in patients with COPD and exertional hypoxemia followed for one year. Methods: Patients experiencing severe hypoxemia during a six-minute walk test (6MWT) performed while breathing room air but not at rest were included in the study. At baseline and after one year of follow-up, all patients were assessed for comorbidities, body composition, SpO2, and dyspnea, as well as for anxiety and depression, having also undergone spirometry, arterial blood gas analysis, and the 6MWT with supplemental oxygen. The Saint George’s Respiratory Questionnaire (SGRQ) was used in order to assess quality of life, and the Body mass index, airflow Obstruction, Dyspnea, and Exercise capacity (BODE) index was calculated. The frequency of exacerbations and the mortality rate were noted. Treatment nonadherence was defined as LTOT use for < 12 h per day or no LTOT use during exercise. Results: A total of 60 patients with COPD and exertional hypoxemia were included in the study. Of those, 10 died and 11 experienced severe hypoxemia during follow-up, 39 patients therefore being included in the final analysis. Of those, only 18 (46.1%) were adherent to LTOT, showing better SGRQ scores, higher SpO2 values, and lower PaCO2 values than did nonadherent patients. In all patients, SaO2, the six-minute walk distance, and the BODE index worsened after one year. There were no differences between the proportions of adherence to LTOT at 3 and 12 months of follow-up. Conclusions: Quality of life appears to be lower in patients with COPD and exertional hypoxemia who do not adhere to LTOT than in those who do. In addition, LTOT appears to have a beneficial effect on COPD symptoms (as assessed by SGRQ scores). (Brazilian Registry of Clinical Trials - ReBEC; identification number RBR-9b4v63 [http://www.ensaiosclinicos.gov.br])

Download Full-text